COVID-19 and Anemia in Children with Nephrotic Syndrome

Abstract

Context: Children with COVID-19 present with less severe disease and require fewer hospitalizations than adults. Our previous study on children with renal disease and COVID-19, which included predominantly children with nephrotic syndrome, found anemia in a significant number of participants. Aims: This study aimed at evaluating the risk factors of anemia in children with nephrotic syndrome presenting with COVID-19 and the influence of anemia on hospital outcome. Methods: This case–control study was conducted at five pediatric nephrology centers in two major cities of Bangladesh. Consecutive patients with nephrotic syndrome and positive polymerase chain reaction (PCR) for severe acute respiratory syndrome coronavirus 2 were included as cases, and subsequently, two cases of nephrotic syndrome with negative PCR were enrolled as controls. Participants who presented between April 2020 and December 2020 were included, and demographic data, clinical features, and laboratory parameters were retrieved from hospital records for analysis. Results: A total of 22 children with nephrotic syndrome were positive with COVID-19 and subsequently, 44 children were included as control. The median age was 6.4 years in the cases and 5.2 years among the control. Most children presented with the initial episode of nephrotic syndrome. The children in the case group had a significantly lower hemoglobin level than the controls, and anemia was associated with raised inflammatory markers. In multivariate analysis, female sex and impaired renal function was associated with lower hemoglobin, but anemia did not have effect on hospital outcome. Conclusions: Anemia in children can be multifactorial. Anemia in nephrotic syndrome associated with COVID-19 does not appear to influence length of hospital stay and outcome.

Burden of Paediatric Kidney Diseases in a Tertiary Care Hospital in Harare, Zimbabwe

“…As shown in other studies in Africa 6 and Bangladesh 23 the most common kidney diseases requiring admission in the unit were AKI, ESKD and nephrotic syndrome. Unlike in India, 24 another developing economy, where post infectious glomerulonephritis is still constituting a majority of admissions, our unit only encountered 5 children (10%) with this condition.…”

“…Mean(SD) age of presentation in our study was 5.5 ± 3.5 years with a M:F ratio of 1.5:1 and most children were aged between 0 and 5 years as seen in other studies. 9 , 23 …”

Zinc as a Supplement in Reduction of Relapses in Children with Nephrotic Syndrome.

“…There was an observed positive correlation between urinary zinc and protein excretion. Children with NS suffer from zinc deficiency which is caused by an increase in the urinary zinc losses despite high dietary intake and normal intestinal absorption [4] Our objective was to study the efficacy of zinc supplementation in reducing the relapse and infection rates in children with frequently relapsing or with steroid dependent nephrotic syndrome.…”