ESPN 54th Annual Meeting

ESPN 2022


 
Acute Kidney Injury Associated with COVID-19 and Multisystem Inflammatory Syndrome in Children (MIS-C)
TUGBA TASTEMEL OZTURK 1 ALI DUZOVA 1 PEMBE DERIN OYGAR 2 DEMET BALTU 1 PELIN OZCILINGIR 3 SIBEL LACINEL GURLEVIK 2 EDA DIDEM KURT-SUKUR 1 HAYRETTIN HAKAN AYKAN 4 SEZA OZEN 5 ILKER ERTUGRUL 4 SELMAN KESICI 6 BORA GULHAN 1 FATIH OZALTIN 1 YASEMIN OZSUREKCI 2 ALI BULENT CENGIZ 2 REZAN TOPALOGLU 1

1- DIVISION OF PEDIATRIC NEPHROLOGY, HACETTEPE UNIVERSITY FACULTY OF MEDICINE, ANKARA, TURKEY
2- DIVISION OF PEDIATRIC INFECTIOUS DISEASES, HACETTEPE UNIVERSITY FACULTY OF MEDICINE, ANKARA, TURKEY
3- DEPARTMENT OF PEDIATRICS, HACETTEPE UNIVERSITY FACULTY OF MEDICINE, ANKARA, TURKEY
4- DIVISION OF PEDIATRIC CARDIOLOGY, HACETTEPE UNIVERSITY FACULTY OF MEDICINE, ANKARA, TURKEY
5- DIVISION OF PEDIATRIC RHEUMATOLOGY, HACETTEPE UNIVERSITY FACULTY OF MEDICINE, ANKARA, TURKEY
6- DIVISION OF PEDIATRIC INTENSIVE CARE, HACETTEPE UNIVERSITY FACULTY OF MEDICINE, ANKARA, TURKEY
 
Introduction:

Data on the characteristics of acute kidney injury (AKI) in pediatric COVID-19 and MIS-C are limited. We aimed to define the frequency, associated factors and early outcome of AKI in COVID-19 and MIS-C.

Material and methods:

Hospitalized patients 18 years of age with confirmed COVID-19 or MIS-C at a tertiary center, between March 2020 - December 2021 were enrolled. AKI was defined and staged according to KDIGO criteria. The characteristics of AKI in the COVID-19 group were investigated in moderate, severe and critically ill patients; outpatients and mild cases who do not have shortness of breath, dyspnea, or abnormal chest imaging were excluded.

Results:

The study included 66 moderate-severe-critically ill patients with COVID-19 (9.71 ± 6.08 years) and 111 MIS-C patients (8.72 ± 4.72 years). The frequency of AKI was 22.7% in COVID-19 and 15.3% in MIS-C; among them AKI was present on admission in 73.3% and 88.2% of COVID-19 and MIS-C groups, respectively. In univariate analyzes, presentation with vomiting/diarrhea, high LDH, D-dimer, troponin and procalcitonin on admission were associated with AKI in COVID-19 patients; whereas older age, low albumin, hemoglobin, thrombocyte, and high CRP, procalcitonin, ferritin, D-dimer, troponin, and BNP levels and low ejection fraction on echocardiography on admission were associated with AKI in MIS-C group. Length of hospital stay was significantly longer in both COVID-19 and MIS-C patients with AKI, compared to those without AKI. Mortality was 9.1% in COVID-19 group; there was no mortality in MIS-C patients. AKI was associated with mortality in COVID-19 patients (p=0.021). Serum creatinine returned to normal level in 96% of survivors before discharge. 

Conclusions:

AKI was seen in 15% of moderate-severe-critically ill COVID-19 group and 23% of MIS-C; it was associated with mortality in COVID-19. Clinical and laboratory parameters associated with AKI were different in COVID-19 and MIS-C. Early outcome was excellent among survivors.