ABSTRACT
BACKGROUND: Acute kidney injury (AKI) is seen in one-fifth of pediatric patients with COVID-19 requiring hospital admission, and is associated with increased morbidity, mortality, and residual kidney impairment. The majority of kidney pathology data in patients with COVID-19 is derived from adult case series and there is an overall lack of histologic data for most pediatric patients with COVID-19. METHODS: We assembled a multi-institutional cohort of five unvaccinated pediatric patients with COVID-19 and associated kidney dysfunction with available histology. RESULTS: Three complex patients with current or prior SARS-CoV-2 infection had multifactorial thrombotic microangiopathy with clinical features of hemolytic uremic syndrome (in two) or disseminated intravascular coagulation (in one); one died and another developed chronic kidney disease stage 5. Two with recently preceding SARS-CoV-2 infection presented with nephrotic syndrome; one had IgA vasculitis and one had minimal change disease. Within a short follow-up time, none has returned to baseline kidney function. CONCLUSION: Although uncommon, COVID-19-associated kidney injury can have significant morbidity in the unvaccinated pediatric and adolescent population. A higher resolution version of the Graphical abstract is available as Supplementary information.
Subject(s)
Acute Kidney Injury , COVID-19 , IgA Vasculitis , Acute Kidney Injury/etiology , Acute Kidney Injury/pathology , Adolescent , Adult , COVID-19/complications , Child , Humans , Kidney/pathology , SARS-CoV-2ABSTRACT
The COVID-19 pandemic created an upheaval for nursing faculty teaching students in both didactic and clinical settings. From the intense disruption, opportunities for creative endeavors emerged. Program directors from a consortium of 12 nursing schools met remotely for problem-solving and support. Rich text from minutes of nine program director meetings were analyzed. Aims of our project included identifying challenges that nurse educators encountered during the pandemic, demonstrating benefits of a university and community college partnership model, and informing nurse educators of innovative outcomes that originated from our project. Thematic analysis of meeting minutes revealed four categories: timing and urgency; collaboration, preparation, and teaching; altruism; and what we learned. Further themes were identified from each of the categories. Innovative outcomes were identified from the text including creation of website teaching resources and development of a computer based clinical checklist. Implications for future nursing education included that computer- based simulation will continue to be embedded in nursing curricula. Also, the need for nursing faculty to remain technologically savvy to deliver trailblazing online pedagogies will prominently continue. We conclude that the synergistic collaboration of nursing program directors can have momentous outcomes for support and success of nursing programs.
Subject(s)
COVID-19 , Education, Nursing, Baccalaureate , Education, Nursing , Students, Nursing , Computers , Faculty, Nursing , Humans , New Mexico , Pandemics , SARS-CoV-2ABSTRACT
In the United States, clinical trials of COVID-19 vaccines and therapeutics quickly exhausted available clinical research capacity at large medical centers. The NIAID Division of Clinical Research tapped community hospitals to help fill the gap.