Coronavirus disease 2019 (<scp>COVID</scp>‐19) in two pediatric patients with kidney disease on chronic immunosuppression: A case series

Rawson, Ashley; Wilson, Amy C.; Schwaderer, Andrew L.; Spiwak, Elizabeth; Johnston, Bethanne; Anderson, Shannon; Nailescu, Corina; Gupta, Sushil K.; Christenson, John C.; Starr, Michelle C.

doi:10.1111/hdi.12876

Cited by 11 publications

(11 citation statements)

References 16 publications

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“…Two studies reported that HD patients tested positive for SARS-CoV-2 RNA on repeated testing despite being negative on two prior consecutive nasopharyngeal swabs [ 138 , 140 ]. Prolonged viral RNA shedding has been reported until 79 days in an adult HD patient [ 140 ] and 28 days in a pediatric patient [ 141 ]. Only one anecdotal case of reinfection has been reported in a dialysis patient [ 142 ].…”

Section: Resultsmentioning

confidence: 99%

“…In research articles reporting clinical manifestation and outcome of COVID-19 patients (78 [54.4%]) the diagnosis of SARS-CoV-2 infection relied principally on RT-PCR (52 [63.4%]) [11-20, 32, 61, 62, 69, 93, 94, 100, 108-111, 113, 115-124, 126, 129, 132, 134, 135, 138-151], serology (4[6.3%]) [18, 20, 22-24, 86, 99], RT-PCR and serological assay (5[6.6%]) [29-31, 85, 127, 152] or a combination of diagnostic tests including clinical evaluation [6,13,19,21,112,114,125,128,130,131,133,136,137,153,154]. Fever, fatigue, poor appetite, headache and lymphopenia at lab tests Chest X-ray negative for COVID-19 lesions Case-report [141] Fever, body aches, cough, fatigue and nasal congestion Case-series (one out of three patients was symptomatic) [149] Outcomes of the confirmed COVID-19 HD patients Outcome of patients on in-centre HD was evaluated on 52 (35.9%) articles including 12,365 patients (range 11-3160) COVID-19 patients (Table 3S). Studies come principally from China (15.3%), Italy (15.3%) and Spain (11.5%); 3.8% of the studies included European authorship.…”

Section: Diagnosismentioning

confidence: 99%

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The frail world of haemodialysis patients in the COVID-19 pandemic era: a systematic scoping review

et al. 2021

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Background Patients undergoing in-centre haemodialysis (HD) are particularly exposed to the dire consequences of COVID-19. The present systematic scoping review aims to identify the extent, range, and nature of articles related to COVID-19 and maintenance HD: it reports specifically the prevalence of the COVID-19 pandemic in the HD population, implementation of strategies for the prevention, mitigation and containment of the COVID-19 pandemic in HD centres, demographic and clinical characteristics, and outcomes of the pediatric and adult HD patients. Methods A multi-step systematic search of the literature in Pubmed, Scopus, Ovid Medline, Embase and Web of Science, published between December 1, 2019, and January 30, 2021 was performed. Two authors separately screened the titles and abstracts of the documents and ruled out irrelevant articles. A report of the papers that met inclusion criteria was performed; then, a descriptive analysis of the characteristics of the included articles and a narrative synthesis of the results were performed. Results The review process ended with the inclusion of 145 articles. Most of them were based on single-centre experiences, which spontaneously developed best practices. Most studies were conducted in high-income countries (69.7%) and a part of them (9.6%) were not in English. Prevalence of COVID-19 among dialysis patients accounted for 0%-37.6%. Preventive measures were reported in 54% of the included articles, with particular emphasis on education, triage, hygiene, and containment measures. Patients experienced a heterogeneous spectrum of symptoms that led 35%-88.2% of them to hospital admission. Median and mean hospital length of stay ranged from 8 to 28.5 and 16.2 to 22 days, respectively. Admission to intensive care units varied widely across studies (from 2.6% to 70.5%) and was associated with high mortality (42.8%-100%). Overall, prognosis was poor in 0%-47% of the hospitalized patients. Conclusions This systematic scoping review provides an overview of the current knowledge on the impact of COVID-19 on the frail world of HD patients. Furthermore, it may help to implement the existing strategies of COVID-19 prevention and provide a list of unmet needs (safe transport, testing, shelter). Finally, it may be a stimulus for performing systematic reviews and meta-analyses which will form the basis for evidence-based guidelines.

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Section: Resultsmentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

The frail world of haemodialysis patients in the COVID-19 pandemic era: a systematic scoping review

et al. 2021

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“…In-center HD patients may represent a high-risk group because of a lack of private transportation and isolated rooms, and being in close contact with other patients and HD staff [20,31]. Private transportation was accessible in 49% of the centers in our study.…”

Section: Discussionmentioning

confidence: 76%

“…Contrary to adult experience [18], based on limited data, PN patients, i.e., hemodialysis (HD) and kidney transplantation patients, and those on immunosuppressive treatment were reported to have a lower risk. In addition, these children did not have an increased risk compared to healthy pediatric populations [19,20].…”

Section: Introductionmentioning

confidence: 99%

Impact of coronavirus disease-2019 on pediatric nephrology practice and education: an ESPN survey

Yazıcıoğlu

Antón‐Gamero²,

Arikoski³

et al. 2021

Pediatr Nephrol

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Background Coronavirus disease-2019 (COVID-19) has been challenging for patients and medical staff. Radical changes have been needed to prevent disruptions in patient care and medical education. Methods A web-based survey was sent to European Society for Pediatric Nephrology (ESPN) members via the ESPN mailing list to evaluate the effects of the COVID-19 pandemic on delivery of pediatric nephrology (PN) care and educational activities. There were ten questions with subheadings. Results Seventy-six centers from 24 countries completed the survey. The time period was between the beginning of the pandemic and May 30, 2020. The number of patients admitted in PN wards and outpatient clinics were significantly decreased (2.2 and 4.5 times, respectively). Telemedicine tools, electronic prescriptions, online applications for off-label drugs, and remote access to laboratory/imaging results were used in almost half of the centers. Despite staff training and protective measures, 33% of centers reported COVID-19 infected staff, and 29% infected patients. Difficulties in receiving pharmaceuticals were reported in 25% of centers. Sixty percent of centers suspended living-related kidney transplantation, and one-third deceased-donor kidney transplantation. Hands-on education was suspended in 91% of medical schools, and faceto-face teaching was replaced by online systems in 85%. Multidisciplinary training in PN was affected in 54% of the centers. Conclusions This survey showed a sharp decline in patient admissions and a significant decrease in kidney transplantation. Telemedicine and online teaching became essential tools, requiring integration into the current system. The prolonged and fluctuating course of the pandemic may pose additional challenges necessitating urgent and rational solutions.

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“…A global study reported no case of severe illness or MIS-C in 113 children with kidney disease in immunosuppressive therapy [5]. Also, a Spanish retrospective study of 26 patients [8] and two case reports [9] described a mild clinical course of infection in children with kidney disease, with no case of PICU admission.…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV2 Related Multi System Inflammatory Syndrome in a Child with Chronic Kidney Disease: Case Report

Stefanachi

Benetti

Longo

et al. 2021

SN Compr. Clin. Med.

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Since April 2020, several paediatric cases were reported with a multisystemic inflammatory syndrome related with SARS-CoV2, called MIS-C. In this case report, we describe a 2-year-old male with end-stage renal disease (ESRD) in renal replacement therapy (RRT) with peritoneal dialysis and severe hypertension affected by a severe SARS-CoV2 related illness characterised by multiorgan failure and need for intensive care, with clinical and instrumental features compatible with MIS-C. Most paediatric patients with kidney disease experience mild SARS-CoV2 disease and to our knowledge, this is the first case of a child with chronic kidney disease suffering from MIS-C. We believe that chronic kidney disease together with dialysis status and severe hypertension play a crucial role on developing severe forms of SARS-CoV2 related disease.

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Coronavirus disease 2019 (COVID‐19) in two pediatric patients with kidney disease on chronic immunosuppression: A case series

Cited by 11 publications

References 16 publications

The frail world of haemodialysis patients in the COVID-19 pandemic era: a systematic scoping review

The frail world of haemodialysis patients in the COVID-19 pandemic era: a systematic scoping review

Impact of coronavirus disease-2019 on pediatric nephrology practice and education: an ESPN survey

SARS-CoV2 Related Multi System Inflammatory Syndrome in a Child with Chronic Kidney Disease: Case Report

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