COVID-19 in pediatric kidney transplantation: a follow-up report of the Improving Renal Outcomes Collaborative

• Published in: Pediatric nephrology (Berlin, West) Vol. 38; no. 2; pp. 537 - 547
• Main Authors: Varnell, Charles, Harshman, Lyndsay A., Liu, Chunyan, Smith, Laurie, Al-Akash, Samhar, Barletta, Gina-Marie, Brakeman, Paul, Chaudhuri, Abanti, Fadakar, Paul, Galea, Lauren, Garro, Rouba, Gluck, Caroline, Kershaw, David B., Matossian, Debora, Patel, Hiren P., Peterson, Caitlin, Pruette, Cozumel, Ranabothu, Saritha, Rodig, Nancy, Singer, Pamela, Sebestyen VanSickle, Judith, Weng, Patricia L., Danziger-Isakov, Lara, Seifert, Michael E., Hooper, David K.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2023; Springer; Springer Nature B.V
• Subjects: Child; Collaboration; Coronaviruses; COVID-19; COVID-19 diagnostic tests; COVID-19 Testing; Death; Epidemiology; Follow-Up Studies; Humans; Kidney transplantation; Kidney Transplantation - adverse effects; Kidney transplants; Kidneys; Medicine; Medicine & Public Health; Nephrology; Original; Original Article; Patients; Pediatric research; Pediatrics; Prospective Studies; Respiratory failure; Risk factors; Transplantation; Urology; United States; COVID-19; Kidney transplant; Improving Renal Outcomes Collaborative
• ISSN: 0931-041X; 1432-198X; 1432-198X
• DOI: 10.1007/s00467-022-05570-w

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. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information