Rates of idiopathic childhood nephrotic syndrome relapse are lower during the COVID-19 pandemic

• Published in: Pediatric nephrology (Berlin, West) Vol. 37; no. 11; pp. 2679 - 2685
• Main Authors: Crane, Clarkson, Bakhoum, Christine, Ingulli, Elizabeth
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.11.2022; Springer Nature B.V
• Subjects: Child; Childhood; Children; Chronic Disease; Coronaviruses; COVID-19; COVID-19 - epidemiology; Disease transmission; Humans; Infections; Kidney diseases; Medicine; Medicine & Public Health; Nephrology; Nephrosis, Lipoid; Nephrotic syndrome; Nephrotic Syndrome - diagnosis; Nephrotic Syndrome - epidemiology; Original; Original Article; Pandemics; Pandemics - prevention & control; Pediatrics; Recurrence; Retrospective Studies; Social distancing; Steroids; Urology; COVID-19; Steroid-sensitive nephrotic syndrome; Nephrotic syndrome relapse; Childhood idiopathic nephrotic syndrome; Pediatric
• ISSN: 0931-041X; 1432-198X; 1432-198X
• DOI: 10.1007/s00467-022-05483-8

Background Infections are thought to be primarily responsible for triggering relapse in children with steroid-sensitive nephrotic syndrome (NS). The COVID-19 pandemic promoted physical distancing, facial mask wearing, and greater attention to infection-prevention measures resulting in decreased transmission of infections. We hypothesized there would also be a decreased rate of NS relapse during this period. Methods We conducted a single-center retrospective chart review of children with steroid-sensitive NS. Demographics, rate of relapses, and rate of hospitalizations were collected for a baseline pre-pandemic period (BPP) and for the social distancing period during the pandemic (SDP). Results One hundred twenty-two children with primary steroid-sensitive NS were identified and 109 were followed for the duration of the study period. The paired rate of relapse per subject per year was significantly lower during the SDP (0.6 relapses per subject per year ± 1 SD) compared to the BPP (1.0 relapses per subject per year ± 0.9 SD), P  < 0.01. A subgroup of 32 subjects who were newly diagnosed with NS during the BPP similarly had significantly fewer relapses during the SDP (0.8 ± 1 SD) than during the BPP (1.4 ± 1 SD), P  = 0.01. Conclusions Our results support the hypothesis of lower rates of NS relapse and hospitalizations during social distancing for all subjects in our cohort and a subgroup of those newly diagnosed. Lower relapse rates were likely attributable to decreased transmission of infections and greater attention to infection prevention. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information