Title

COVID-19 in pediatric kidney transplantation: a follow-up report of the Improving Renal Outcomes Collaborative.

Authors

Charles Varnell
Lyndsay A Harshman
Chunyan Liu
Laurie Smith
Samhar Al-Akash
Gina-Marie Barletta
Paul Brakeman
Abanti Chaudhuri
Paul Fadakar
Lauren E. Galea, Children's Hospital of Philadelphia, Philadelphia, PAFollow
Rouba Garro
Caroline Gluck
David B Kershaw
Debora Matossian
Hiren P Patel
Caitlin Peterson
Cozumel Pruette
Saritha Ranabothu
Nancy Rodig
Pamela Singer
Judith Sebestyen VanSickle
Patricia L Weng
Lara Danziger-Isakov
Michael E Seifert
David K Hooper

Publication Title

Pediatric nephrology (Berlin, Germany)

Document Type

Article

PubMed ID

35538239

Abstract

BACKGROUND: We report follow-up data from an ongoing prospective cohort study of COVID-19 in pediatric kidney transplantation through the Improving Renal Outcomes Collaborative (IROC).

METHODS: Patient-level data from the IROC registry were combined with testing, indication, and outcomes data collected to describe the epidemiology of COVID testing, treatment, and clinical outcomes; determine the incidence of a positive COVID-19 test; describe rates of COVID-19 testing; and assess for clinical predictors of a positive COVID-19 test.

RESULTS: From September 2020 to February 2021, 21 centers that care for 2690 patients submitted data from 648 COVID-19 tests on 465 patients. Most patients required supportive care only and were treated as outpatients, 16% experienced inpatient care, and 5% experienced intensive care. Allograft complications were rare, with acute kidney injury most common (7%). There was 1 case of respiratory failure and 1 death attributed to COVID-19. Twelve centers that care for 1730 patients submitted complete testing data on 351 patients. The incidence of COVID-19 among patients at these centers was 4%, whereas the incidence among tested patients was 19%. Risk factors to predict a positive COVID-19 test included age > 12 years, symptoms consistent with COVID-19, and close contact with a confirmed case of COVID-19.

CONCLUSIONS: Despite the increase in testing and positive tests over this study period, the incidence of allograft loss or death related to COVID-19 remained extremely low, with allograft loss or death each occurring in < 1% of COVID-19-positive patients and in less than < 0.1% of all transplant patients within the IROC cohort. A higher resolution version of the Graphical abstract is available as Supplementary information.

Keywords

Humans, Child, Kidney Transplantation, COVID-19, COVID-19 Testing, Follow-Up Studies, Prospective Studies

DOI

10.1007/s00467-022-05570-w

Publication Date

2-1-2023

Citation

Varnell, C., Harshman, L., Liu, C., Smith, L., Al-Akash, S., Barletta, G., Brakeman, P., Chaudhuri, A., Fadakar, P., Galea, L. E., Garro, R., Gluck, C., Kershaw, D., Matossian, D., Patel, H., Peterson, C., Pruette, C., Ranabothu, S., Rodig, N., Singer, P., Sebestyen VanSickle, J., Weng, P., Danziger-Isakov, L., Seifert, M., & Hooper, D. (2023). COVID-19 in pediatric kidney transplantation: a follow-up report of the Improving Renal Outcomes Collaborative.. Pediatric nephrology (Berlin, Germany), 38 (2), 537-547. https://doi.org/10.1007/s00467-022-05570-w