Abstract
BackgroundAcute kidney injury (AKI) is a complication of coronavirus disease 2019 (COVID-19). The reported incidence of AKI, however, varies among studies. We aimed to evaluate the incidence of AKI and its association with mortality and morbidity in children infected with severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) who required hospital admission.MethodsThis was a multicenter retrospective cohort study from three tertiary centers, which included children with confirmed COVID-19. All children were evaluated for AKI using the Kidney Disease Improving Global Outcomes (KDIGO) definition and staging.ResultsOf 89 children included, 19 (21 %) developed AKI (52.6 % stage I). A high renal angina index score was correlated with severity of AKI. Also, multisystem inflammatory syndrome in children (MIS-C) was increased in children with AKI compared to those with normal kidney function (15 % vs. 1.5 %). Patients with AKI had significantly more pediatric intensive care admissions (PICU) (32 % vs. 2.8 %, p < 0.001) and mortality (42 % vs. 0 %, p < 0.001). However, AKI was not associated with prolonged hospitalization (58 % vs. 40 %, p = 0.163) or development of MIS-C (10.5 % vs. 1.4 %, p = 0.051). No patient in the AKI group required renal replacement therapy. Residual renal impairment at discharge occurred in 9 % of patients. This was significantly influenced by the presence of comorbidities, hypotension, hypoxia, heart failure, acute respiratory distress, hypernatremia, abnormal liver profile, high C-reactive protein, and positive blood culture.ConclusionsAKI occurred in one-fifth of children with SARS-CoV-2 infection requiring hospital admission, with one-third of those requiring PICU. AKI was associated with increased morbidity and mortality, and residual renal impairment at time of discharge.
Highlights
Acute kidney injury (AKI) is a complication of coronavirus disease 2019 (COVID-19)
We examined data from all children admitted with COVID-19 to estimate the prevalence of AKI and its associated risk factors, as well as the required care of those children
Eighty-nine children admitted with a confirmed diagnosis of COVID-19 were included in this study
Summary
Acute kidney injury (AKI) is a complication of coronavirus disease 2019 (COVID-19). We aimed to evaluate the incidence of AKI and its association with mortality and morbidity in children infected with severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) who required hospital admission. Coronavirus disease 2019 (COVID-19) is a new disease that emerged in China in late 2019 [1]. Since it has caused an unprecedented health, social, and economic crisis. Acute kidney injury (AKI) is a complication of COVID19 and the pathophysiology of AKI in COVID-19 appears to be multifactorial. Other factors found in similar diseases have been described, including hypovolemia, heart failure (both right and left), sepsis, and dehydration [5, 6].
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