Clinical features and outcomes of renal disease in children with COVID-19: A single-center retrospective study

Abstract

Abstract Background: The clinical spectrum of coronavirus disease 2019 (COVID-19) ranges from asymptomatic course to severe illness. Children have accounted 1%–5% of diagnosed cases so far. This study aimed to observe the clinical features and outcomes of renal disease in children with COVID-19. Materials and Methods: This retrospective study was conducted in the Department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from November 2021 to April 2022. The data were collected from 24 COVID-19-positive children under 18 years old with preexisting renal disease admitted in BSMMU from March 2020 to September 2021. Results: The mean age of the participants was 8.7 (±4.4) years. Among them, preexisting renal diseases were mainly nephrotic syndrome (50%), chronic kidney diseases (29%), and lupus nephritis (8%). Among the participants, 58% of patients became reverse transcription- polymerase chain reaction negative within 14 days, and the mean duration of hospital stay was 14.5 (±5.9) days. Most frequently presented clinical features were fever (75%), cough (71%), respiratory distress (54%), proteinuria (71%), hematuria (21%), diarrhea and acute kidney injury (17%), rapidly progressive glomerulonephritis (4%), heart failure (33%), and decreased saturation of peripheral oxygen ≤90% in 58% of cases. Mean white blood cell count was 8773.9 (±5178.1)/mm3, raised serum creatinine 62.5%. Pneumonia in chest X-ray was present in 50% of cases. Children getting more immunosuppressive drugs, especially those who got rituximab, had milder symptoms. Overall case-fatality rate was 25% with the highest rate in chronic kidney disease (CKD) patients. Conclusion: Children with preexisting renal disease got affected slightly at a higher percentage than the normal child, and those who got immunosuppressive therapy, especially rituximab, had milder symptoms. Children with CKD had fatal outcomes.