ESPN 54th Annual Meeting

ESPN 2022


 
COVID-19 infection and immune response in pediatric kidney transplant patients
YOLANDA CALZADA BAñOS 1 MARTA JIMéNEZ MORENO 1 ANA CRISTINA AGUILAR RODRíGUEZ 1 PEDRO ARANGO SANCHO 1 CLAUDIA FORTUNY GUASCH 1 RAQUEL JIMéNEZ GARCíA 1 ELENA CODINA SAMPERA 1 ÁLVARO MADRID ARIS 1

1- HOSPITAL SANT JOAN DE DéU
 
Introduction:

 COVID-19 has had high morbidity and mortality in kidney transplant patients (RT) and other solid organs.However, its clinical course in pediatric recipients remains poorly defined,with few reported cases.The objective of the study is to characterize the evolution of SARS-Cov-2 infection in pediatric RT as well as to study the humoral response developed after it

Material and methods:

Descriptive prospective single-center study started in October 2020.RT patients aged 18 years or younger under follow-up at our center with a diagnosis of SARS-CoV-2 infection by PCR technique,indicated by the presence of symptoms and/or signs,are included.Suggestive of infection or by study of contacts in confirmed cases. Demographic,clinical and analytical variables,seroconversion study (IgM and IgG) and biobank samples for subsequent study of cellular response and interleukins are analyzed

Results:

Six patients are included,predominantly female (83.3%);median age of 13.5 years (7-16) and median time post-RT of 31.5 months (6-120).2 patients (33.3%) had high blood pressure,1 had diabetes mellitus,1 was overweight (BMI 25.8) and 1 was obese (BMI 30.9),none had underlying heart disease or lung disease.The most frequent maintenance immunosuppression was tacrolimus,mycophenolate and prednisone (50%).Half of the patients were diagnosed during a school contact study,and the other 50% as a result of family cases,none of which was an index case.2 patients (33.3%) were asymptomatic.The most frequent symptom was cough (4,66.7%) followed by asthenia (2),fever (1) and diarrhea (1).One patient presented mild bronchospasm without hypoxemia,normal chest X-ray.The most frequent analytical finding was lymphopenia or its worsening (5,83.3%) and ferritin elevation (66.7%),with erythrocyte sedimentation rate (ESR),procalcitonin and C-reactive protein being negative in all cases.Mild elevation of D-dimer in 2 patients.No patient presented graft dysfunction.No patient required hospitalization or adjustment of immunosuppression.4 patients (66.7%) developed IgM and IgG that are maintained at 6 months post-infection.2 patients (33.3%) did not present seroconversion,of which 1 presented positivization of IgM and IgG after 3 months,being oriented as asymptomatic reinfection.It remains to analyze cellular response at the time of analysis

Conclusions:

In our pediatric RT cohort,COVID-19 appears to have a benign course similar to studies in non-immunosuppressed children.The study of cellular immunity remains pending at the time of the analysis