Pathology findings in pediatric patients with COVID-19 and kidney dysfunction

Background Acute kidney injury (AKI) is seen in one-fifth of pediatric patients with COVID-19 requiring hospital admission, and is associated with increased morbidity, mortality, and residual kidney impairment. The majority of kidney pathology data in patients with COVID-19 is derived from adult cas...

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Veröffentlicht in:Pediatric nephrology (Berlin, West) West), 2022-10, Vol.37 (10), p.2375-2381
Hauptverfasser: Nomura, Eric, Finn, Laura S., Bauer, Abbie, Rozansky, David, Iragorri, Sandra, Jenkins, Randall, Al-Uzri, Amira, Richardson, Kelsey, Wright, Mary, Kung, Vanderlene L., Troxell, Megan L., Andeen, Nicole K.
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Sprache:eng
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Zusammenfassung:Background Acute kidney injury (AKI) is seen in one-fifth of pediatric patients with COVID-19 requiring hospital admission, and is associated with increased morbidity, mortality, and residual kidney impairment. The majority of kidney pathology data in patients with COVID-19 is derived from adult case series and there is an overall lack of histologic data for most pediatric patients with COVID-19. Methods We assembled a multi-institutional cohort of five unvaccinated pediatric patients with COVID-19 and associated kidney dysfunction with available histology. Results Three complex patients with current or prior SARS-CoV-2 infection had multifactorial thrombotic microangiopathy with clinical features of hemolytic uremic syndrome (in two) or disseminated intravascular coagulation (in one); one died and another developed chronic kidney disease stage 5. Two with recently preceding SARS-CoV-2 infection presented with nephrotic syndrome; one had IgA vasculitis and one had minimal change disease. Within a short follow-up time, none has returned to baseline kidney function. Conclusion Although uncommon, COVID-19-associated kidney injury can have significant morbidity in the unvaccinated pediatric and adolescent population. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information .
ISSN:0931-041X
1432-198X
DOI:10.1007/s00467-022-05457-w