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Pathology findings in pediatric patients with COVID-19 and kidney dysfunction.
Nomura, Eric; Finn, Laura S; Bauer, Abbie; Rozansky, David; Iragorri, Sandra; Jenkins, Randall; Al-Uzri, Amira; Richardson, Kelsey; Wright, Mary; Kung, Vanderlene L; Troxell, Megan L; Andeen, Nicole K.
  • Nomura E; Department of Pathology and Laboratory Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA.
  • Finn LS; Department of Pathology, Children's Hospital of Philadelphia, Philadelphia, USA.
  • Bauer A; Division of Pediatric Nephrology and Hypertension, Oregon Health & Science University, Portland, USA.
  • Rozansky D; Division of Pediatric Nephrology and Hypertension, Oregon Health & Science University, Portland, USA.
  • Iragorri S; Division of Pediatric Nephrology and Hypertension, Oregon Health & Science University, Portland, USA.
  • Jenkins R; Division of Pediatric Nephrology and Hypertension, Oregon Health & Science University, Portland, USA.
  • Al-Uzri A; Division of Pediatric Nephrology and Hypertension, Oregon Health & Science University, Portland, USA.
  • Richardson K; Division of Pediatric Nephrology and Hypertension, Oregon Health & Science University, Portland, USA.
  • Wright M; Division of Pediatric Nephrology and Hypertension, Oregon Health & Science University, Portland, USA.
  • Kung VL; Department of Pathology and Laboratory Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA.
  • Troxell ML; Department of Pathology, Stanford University, Stanford, USA.
  • Andeen NK; Department of Pathology and Laboratory Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA. andeen@ohsu.edu.
Pediatr Nephrol ; 37(10): 2375-2381, 2022 10.
Article in English | MEDLINE | ID: covidwho-1680823
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: IgA Vasculitis / Acute Kidney Injury / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Adolescent / Adult / Child / Humans Language: English Journal: Pediatr Nephrol Journal subject: Nephrology / Pediatrics Year: 2022 Document Type: Article Affiliation country: S00467-022-05457-w

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Full text: Available Collection: International databases Database: MEDLINE Main subject: IgA Vasculitis / Acute Kidney Injury / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Adolescent / Adult / Child / Humans Language: English Journal: Pediatr Nephrol Journal subject: Nephrology / Pediatrics Year: 2022 Document Type: Article Affiliation country: S00467-022-05457-w