SARS-CoV-2 infection in children with chronic kidney disease.
Pediatr Nephrol
; 37(4): 849-857, 2022 04.
Article
in English
| MEDLINE | ID: covidwho-1406162
ABSTRACT
BACKGROUND:
Information on the course of SARS-CoV-2 infection in children with chronic kidney disease (CKD) is limited.METHODS:
We retrospectively reviewed the presentation and outcomes of SARS-CoV-2 infection in patients with CKD followed at any of the four pediatric nephrology centers in New Delhi from April 2020 to June 2021. Outcomes, including cardiopulmonary and renal complications, were reported in relation to underlying disease category and illness severity at presentation.RESULTS:
Underlying illness in 88 patients included nephrotic syndrome (50%), other CKD stages 1-4 (18.2%), CKD 5D (17%), and CKD 5T (14.8%). Thirty-two of 61 patients with symptomatic COVID-19 and 9/27 asymptomatic patients were admitted for median 10 (interquartile range 7-15) days. Seventeen (19.3%) patients developed moderate or severe COVID-19. Systemic complications, observed in 30 (34.1%), included acute kidney injury (AKI, 34.2%), COVID-19 pneumonia (15.9%), unrelated pulmonary disease (2.3%), and shock (4.5%). Nineteen (21.6%) had severe complications (AKI stage 2-3, encephalopathy, respiratory failure, shock). Eight (11%) of twelve (16.4%) patients with severe AKI required dialysis. Three (3.4%) patients, two with steroid-resistant nephrotic syndrome in relapse and one with CKD 1-4, died due to respiratory failure. Univariate logistic regression indicated that patients presenting with nephrotic syndrome in relapse or moderate to severe COVID-19 were at risk of AKI (respective odds ratio, 95%CI 3.62, 1.01-12.99; 4.58, 1.06-19.86) and/or severe complications (respective odds ratio, 95%CI 5.92, 1.99-17.66; 61.2, 6.99-536.01).CONCLUSIONS:
Children with CKD presenting with moderate-to-severe COVID-19 or in nephrotic syndrome relapse are at risk of severe complications, including severe AKI and mortality. A higher resolution version of the Graphical abstract is available as Supplementary information.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Renal Insufficiency, Chronic
/
Acute Kidney Injury
/
COVID-19
Type of study:
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Child
/
Humans
Language:
English
Journal:
Pediatr Nephrol
Journal subject:
Nephrology
/
Pediatrics
Year:
2022
Document Type:
Article
Affiliation country:
S00467-021-05218-1
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