COVID-19 in pediatric kidney transplantation: a follow-up report of the Improving Renal Outcomes Collaborative.
DOI: 10.1007/s00467-022-05570-w; PMCID: PMC9090538
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.
Pediatric nephrology (Berlin, Germany)
Humans; Child; Kidney Transplantation; COVID-19; COVID-19 Testing; Follow-Up Studies; Prospective Studies
COVID-19; Improving Renal Outcomes Collaborative; Kidney transplant
Varnell C Jr, Harshman LA, Liu C, et al. COVID-19 in pediatric kidney transplantation: a follow-up report of the Improving Renal Outcomes Collaborative. Pediatr Nephrol. 2023;38(2):537-547. doi:10.1007/s00467-022-05570-w