Akademik Veri Yönetim Sistemi
53rd ESPN Annual Meeting, Amsterdam, Hollanda, 3 - 04 Eylül 2021, ss.3417-3418
Introduction: Contrary to our initial expectations, the prolonged and
fluctuating course of COVID-19 pandemic has a significant impact on
our medical practice. Despite significantly lower disease transmission
among children, cases have been increasing steeply. We aimed to evaluate demographic findings and outcomes of pediatric nephrology patients
with COVID-19 in Turkey.
Material and methods: An online survey was sent to all centers to
collect the data.
Results: Diagnosis of COVID-19 was made in 203 children with 114
infected family members. While the disease was most commonly seen in
the age group of 10-15 years (37%), it was less common in children under
2 years (5,4 %) and those between 2-5 years of age (8,9%). Renal transplantation (27,6%), hemodialysis (16,3%), and glomerulopathies (15,3%)
were the most common diagnostic categories. At least one comorbid condition was observed in half of the patients, while 15 % had multiple
comorbidities.
Only 42,4% of patients were admitted to the hospital due to complaints
and 43,8% were diagnosed with screening tests because of infected family members or, routine PCR test before hospital admission. The remaining 13.8% of the patients were diagnosed at another center. The primary
method for diagnosis was SARS CoV-2 PCR test and it was positive in
84% of the patients. Other methods for diagnosis were SARS CoV-2
serology (5,9 %), thorax CT (5,4 %) and high clinical suspicion (4,9%).
60 % of patients were asymptomatic or had mild disease, while among 82
hospitalized ones, 23 (28% of hospitalized patients, 11,3% of all patients)
required ICU care. Treatment regimens were highly heterogenous. Half
of the patients (55%) were not treated, while remaining patients were
mostly given favipiravir (20,7%), steroid (16,3 %) and
hydroxychloroquine (11,3 %). Some of the patients were treated with
additional combination regimens of intravenous immunoglobulin, low
molecular weight heparin or biologic anti-cytokine therapies.
The patients were most frequently hospitalized for >3-7 days (35,4 %)
and >7-14 days (31,7 %). Only seven patients required >30 days of
hospitalization. Acute kidney injury developed in 20% of the hospitalized
patients during the course of the disease. Five patients had the diagnosis
of MIS-C and three of them died. Another two patients died due to
COVID pneumonia, one post-COVID cardiac arrest at home after discharge and one COVID-unrelated reasons. Fortunately, 83% of the patients were discharged without any apparent sequelae. On the other hand,
108 health care staff including 42 physician (25 of them pediatric nephrologist), 15 secretary, 15 cleaning staff, 14 pediatric’s nurse and 13 hemodialysis (HD) nurse were infected during the study period.
Conclusions: COVID-19 was most commonly seen in patients with renal
transplantation, undergoing HD and having glomerulopathy. Combined
immunosuppressive therapy and exposure in-center HD may increase
these patients susceptibility. A mortality rate of 3.4% and staff infections
deserve more attention and further precautions.