ESPN 54th Annual Meeting

ESPN 2022


 
COVID-19 in children with chronic kidney disease; does it differ much?
DEMET BALTU 1 EDA DIDEM KURT SUKUR 1 TUGBA TASTEMEL OZTURK 1 BORA GULHAN 1 FATIH OZALTIN 1 ALI DUZOVA 1 REZAN TOPALOGLU 1

1- DEPARTMENT OF PEDIATRIC NEPHROLOGY, FACULTY OF MEDICINE, HACETTEPE UNIVERSITY, ANKARA, TURKEY
 
Introduction:

Although the clinical course of coronavirus disease-2019 (COVID-19) is milder in children, more data on pediatric chronic kidney disease (CKD) is needed. This study aimed to assess the incidence and severity of COVID-19 in pediatric CKD patients followed up at a tertiary center.

Material and methods:

A questionnaire including demographics, COVID-19 history, symptoms, vaccination status was applied to patients with glomerular disease treated with immunosuppression, CKD stage 2–5, dialysis patients, and kidney transplant recipients followed up between March 2020-January 2022. Medical records were retrospectively reviewed. Acute kidney injury (AKI) was staged according to KDIGO criteria. COVID-19 was diagnosed by polymerase chain reaction in nasal swab samples and severity was categorized according to the National Institute of Health criteria.

Results:

 220 patients were included, 48 were found (21.8%) to have experienced COVID-19. There was no significant difference regarding age, gender, underlying kidney disease, CKD stage, dialysis status, type or number of immunosuppressive medications, and glomerular filtration rate between patients with and without COVID-19 history. Mean age of COVID-19 positive patients was 14.04 ± 4.12 years. Most were infected by a household member (43.8%) and during outpatient or inpatient care (18.8%). Four (8.3%) were asymptomatic, 43 (89.6%) had mild infection. Eleven (22.9%) patients were hospitalized, severe COVID-19 was observed in only one patient with kidney transplant who needed non-invasive mechanical ventilation. Eleven (22.9%) patients with COVID-19 were previously vaccinated (mostly two doses of BNT162b2 messenger RNA). Laboratory tests were available in 19 patients, AKI was detected in 4 (8.3%); as stage 1 in all. Median follow-up after COVID-19 was 4.6 (IQR;7.5) months. During follow-up one patient (with lupus nephritis) had re-infection, no patient developed multisystem inflammatory syndrome. All patients fully recovered, no renal flare or death was observed.

Conclusions:

Although the vaccination rate was low in our cohort, majority of the children with COVID-19 showed a mild course. Along with the vaccination, general precautions seemed to be successful for this population.