Abstract
BackgroundThis is a case report of an asymptomatic SARS-CoV-2 infection associated with new-onset nephrotic syndrome in a pediatric patient. This is the third case of new-onset nephrotic syndrome in children associated with SARS-CoV-2 infection, but is the first case report describing a new-onset nephrotic syndrome presentation in a patient who had asymptomatic COVID-19 infection.Case presentationThis is a case of a previously healthy 5 year old female who presented with new-onset nephrotic syndrome in the setting of an asymptomatic COVID-19 infection. She presented with progressive edema, and laboratory findings were significant for proteinuria and hypercholesterolemia. She was treated with albumin, diuretics, and corticosteroid therapy, and achieved clinical remission of her nephrotic syndrome within 3 weeks of treatment. Though she was at risk of hypercoagulability due to her COVID-19 infection and nephrotic syndrome, she was not treated with anticoagulation, and did not develop any thrombotic events.ConclusionsOur case report indicates that SARS-CoV-2 infection could be a trigger for nephrotic syndrome, even in the absence of overt COVID-19 symptoms.
Highlights
This is a case report of an asymptomatic SARS-CoV-2 infection associated with new-onset nephrotic syndrome in a pediatric patient
Our case report indicates that SARS-CoV-2 infection could be a trigger for nephrotic syndrome, even in the absence of overt COVID-19 symptoms
Presentations of COVID-19 in children vary: the virus can cause severe symptoms upon initial infection, but children are affected by multisystem inflammatory syndrome in children (MIS-C), which often occurs weeks after initial infection [4, 5]
Summary
Since the outbreak of the COVID-19 pandemic, more than 20 million people in the United States alone have been infected with the SARS-Cov-2 virus, and over 350,000 of these people have died [1]. The surveillance COVID-19 testing (RT-PCR, performed via nasopharyngeal swab), which was performed as part of the general hospital admission process during the time of this case report, returned positive for SARS-CoV-2, and further immunoglobulin (Ig) testing was positive for both IgM and IgG antibodies. In addition to a fluid and sodium restriction, she started on oral vitamin D supplements and following a negative purified protein derivative (PPD) skin test, she started corticosteroid therapy at 2 mg/kg per day Throughout her four-day hospital stay, patient remained asymptomatic from COVID-19 perspective. Patient was in complete remission within 3 weeks of starting corticosteroids and urine protein was still negative after 6 weeks of therapy Her coagulation profile and thyroid studies normalized without intervention; she remains positive for both IgM and IgG SARSCov-2 antibodies. She had still remained asymptomatic from a COVID-19 perspective at her follow up visit
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