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. Graphical abstract: A higher resolution version of the Graphical abstract is available as Supplementary information.[Figure not available: see fulltext.].
Original language | English (US) |
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Pages (from-to) | 2375-2381 |
Number of pages | 7 |
Journal | Pediatric Nephrology |
Volume | 37 |
Issue number | 10 |
DOIs | |
State | Published - Oct 2022 |
Keywords
- AKI
- Acute kidney injury
- COVID-19
- Glomerulonephritis
- HSP
- HUS
- Hemolytic uremic syndrome
- Henoch-Schönlein purpura
- IgA vasculitis
- Kidney biopsy
- Kidney dysfunction
- Nephrotic syndrome
- Proteinuria
- Renal pathology
- SARS-CoV-2
- TMA
- Thrombotic microangiopathy
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Nephrology