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Archivos de Pediatría del Uruguay
Print version ISSN 0004-0584On-line version ISSN 1688-1249
Abstract
HALTY, Margarita et al. SARS-CoV-2 infection in children under 15 years old with glomerulopathies in Uruguay: Clinical features, severity and evolution. Arch. Pediatr. Urug. [online]. 2024, vol.95, n.2, e215. Epub Dec 01, 2024. ISSN 0004-0584. https://doi.org/10.31134/ap.95.2.4.
Introduction:
infections can trigger a relapse in children with glomerulopathies (GP); the SARS-CoV-2 infection can have consequences for the cases of kidney disease comorbidity and for cases when patients receive immunosuppression (IS).
Objectives:
describe the SARS-CoV-2 infection severity in children with GP and assess the clinical course of the kidney disease.
Methodology:
we conducted a multicenter retrospective study in Uruguay (04/01/2020 - 06/30/2022) of children <15 years of age with a chronic GP, either on IS treatment or not, who presented a confirmed SARS-CoV-2 infection. We collected demographic, clinical, treatment, and patient evolution data.
Results:
we included 30 children, 18 boys, median age 9 years, 16 (53%) had an idiopathic nephrotic syndrome (INS), 28 (93%) had received some IS treatment, 23 (77%) were taking it at the time of the infection. Respiratory symptoms were mild in all patients; 6/30 (20%) were asymptomatic. The peak incidence (86.6%) occurred between January-May/2022; 7/30 (23.3%) had renal repercussions. Two patients (6,6%) were hospitalized with acute kidney failure: one (3,3%), with IgA nephropathy, presented with emergency hypertension and required hemodialysis, and the other one (3,3%), with IgM nephropathy, presented with nephrotic syndrome. Three children (10%) with INS relapsed (2 (6,6%) were asymptomatic) and 2 (6,6%) had no nephrotic proteinuria. All patients recovered their previous situation, 6/7 (85,7%) with steroids. Mophetil mycophenolate was temporarily reduced in 3/11 (27,2%) children and stopped in one (9%). None with lupus relapsed (n=4). None required oxygen, nor did they present multisystem inflammatory syndrome. No deaths were recorded.
Conclusions:
despite the low frequency of complications and good outcome, pediatric patients with COVID-19 should be monitored. Relapse can occur in asymptomatic infections.
Keywords : COVID-19; Glomerulonephritis; Immunosuppressants; Child; Adolescent.