Peritoneal dialysis for treatment of acute kidney injury in a case of paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2

McCulloch, Mignon; Abugrain, Khadija; Mosalakatane, Thembisile; Coetzee, Anina; Webb, Kate; Scott, Christiaan

doi:10.1177/0896860820953716

Cited by 9 publications

(4 citation statements)

References 6 publications

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“…Participants: MIS-C: Children under the age of 18 years old admitted to the two main paediatric referral hospitals in Cape Town; the Red Cross War Memorial Children's Hospital (RXH) or Tygerberg Academic Hospital (TBH) between 7 May 2020 and 31 March 2021 with con rmed MIS-C as per the WHO criteria[16] were offered recruitment with consent. Twenty three cases were previously reported in a letter in August 2020 [9], and four patients have been reported in a renal case series [17].…”

Section: Methodsmentioning

confidence: 99%

The Clinical Features and Estimated Incidence of MIS-C in Cape Town, South Africa

Butters

Abraham

Stander

et al. 2022

Preprint

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Background Multisystem inflammatory syndrome is a severe manifestation of SARS-CoV-2 in children. The incidence of MIS-C after infection is poorly understood. There are very few cohorts describing MIS-C in Africa despite MIS-C being more common in Black children worldwide. Methods A cohort of children with MIS-C and healthy children was recruited from May 2020 until May 2021 from the two main paediatric hospitals in Cape Town, South Africa. Clinical and demographic data were collected, and serum was tested for SARS-CoV-2 antibodies. The incidence of MIS-C was calculated using an estimation of population exposure from seroprevalence in the healthy group. Summary data, non-parametric comparisons and logistic regression analyses were performed. Results 68 children with MIS-C were recruited with a median age of 7 years (3.6, 9.9). 97 healthy children were recruited with a 30% seroprevalence. The estimated incidence of MIS-C was 22/100 000 exposures in the city in this time. Black children were over-represented in the MIS-C group (62% vs 37%, p=0.002). The most common clinical features in MIS-C were fever (100%), tachycardia (98.5%), rash (85.3%), conjunctivitis (77.9%), abdominal pain (60.3%) and hypotension (60.3%). The median haemoglobin, sodium, neutrophil count, white cell count, CRP, ferritin, cardiac (pro-BNP, trop-T) and coagulation markers (D-dimer and fibrinogen) were markedly deranged in MIS-C. Cardiac, pulmonary, central nervous and renal organ systems were involved in 71%, 29.4%, 27.9% and 27.9% respectively. 94.1% received intravenous immune globulin, 64.7% received methylprednisolone and 61.7% received both. 39.7% required ICU admission, 38.2% required inotropic support, 38.2% required oxygen therapy, 11.8% required invasive ventilation and 6% required peritoneal dialysis. Older age was an independent predictor for the requirement for ionotropic support (OR=1.523, CI 1.074, 2.16, p=0.018). The median hospital stay duration was 7 days with no deaths. Conclusion The lack of reports from Southern Africa does not reflect a lack of cases of MIS-C. MIS-C poses a significant burden to children in the region as long as the pandemic continues. MIS-C disproportionately affects black children. The clinical manifestations and outcomes of MIS-C in this region highlight the need for improved surveillance, reporting and data to inform diagnosis and treatment.

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Section: Methodsmentioning

confidence: 99%

The Clinical Features and Estimated Incidence of MIS-C in Cape Town, South Africa

Butters

Abraham

Stander

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…Children under the age of 18 years old admitted to the two main paediatric referral hospitals in Cape Town; the Red Cross War Memorial Children’s Hospital (RXH) or Tygerberg Academic Hospital (TBH) between 7 May 2020 and 31 March 2021 with confirmed MIS-C as per the WHO criteria [ 16 ] were offered recruitment with consent. Twenty three cases were previously reported in a letter in August 2020 [ 9 ], and four patients have been reported in a renal case series [ 17 ].…”

Section: Methodsmentioning

confidence: 99%

The clinical features and estimated incidence of MIS-C in Cape Town, South Africa

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background Multisystem inflammatory syndrome is a severe manifestation of SARS-CoV-2 in children. The incidence of MIS-C after infection is poorly understood. There are very few cohorts describing MIS-C in Africa despite MIS-C being more common in Black children worldwide. Methods A cohort of children with MIS-C and healthy children was recruited from May 2020 until May 2021 from the two main paediatric hospitals in Cape Town, South Africa. Clinical and demographic data were collected, and serum was tested for SARS-CoV-2 antibodies. The incidence of MIS-C was calculated using an estimation of population exposure from seroprevalence in the healthy group. Summary data, non-parametric comparisons and logistic regression analyses were performed. Results Sixty eight children with MIS-C were recruited with a median age of 7 years (3.6, 9.9). Ninety seven healthy children were recruited with a 30% seroprevalence. The estimated incidence of MIS-C was 22/100 000 exposures in the city in this time. Black children were over-represented in the MIS-C group (62% vs 37%, p = 0.002). The most common clinical features in MIS-C were fever (100%), tachycardia (98.5%), rash (85.3%), conjunctivitis (77.9%), abdominal pain (60.3%) and hypotension (60.3%). The median haemoglobin, sodium, neutrophil count, white cell count, CRP, ferritin, cardiac (pro-BNP, trop-T) and coagulation markers (D-dimer and fibrinogen) were markedly deranged in MIS-C. Cardiac, pulmonary, central nervous and renal organ systems were involved in 71%, 29.4%, 27.9% and 27.9% respectively. Ninety four percent received intravenous immune globulin, 64.7% received methylprednisolone and 61.7% received both. Forty percent required ICU admission, 38.2% required inotropic support, 38.2% required oxygen therapy, 11.8% required invasive ventilation and 6% required peritoneal dialysis. Older age was an independent predictor for the requirement for ionotropic support (OR = 1.523, CI 1.074, 2.16, p = 0.018). The median hospital stay duration was 7 days with no deaths. Conclusion The lack of reports from Southern Africa does not reflect a lack of cases of MIS-C. MIS-C poses a significant burden to children in the region as long as the pandemic continues. MIS-C disproportionately affects black children. The clinical manifestations and outcomes of MIS-C in this region highlight the need for improved surveillance, reporting and data to inform diagnosis and treatment.

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“…Con respecto a las manifestaciones renales, se han reportado casos de daño renal agudo, pero también casos que han requerido diálisis. 44,45 Feng et al 43…”

Section: Epidemiologíaunclassified

Untitled

2023

Acta Pediatr Mex

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Peritoneal dialysis for treatment of acute kidney injury in a case of paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2

Cited by 9 publications

References 6 publications

The Clinical Features and Estimated Incidence of MIS-C in Cape Town, South Africa

The Clinical Features and Estimated Incidence of MIS-C in Cape Town, South Africa

The clinical features and estimated incidence of MIS-C in Cape Town, South Africa

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