COVID-19 in pediatric kidney transplantation: a follow-up report of the Improving Renal Outcomes Collaborative
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 collecte...
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| Published in | Pediatric nephrology (Berlin, West) Vol. 38; no. 2; pp. 537 - 547 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Berlin/Heidelberg
Springer Berlin Heidelberg
01.02.2023
Springer Springer Nature B.V |
| Subjects | |
| Online Access | Get full text |
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| Abstract | 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 |
|---|---|
| AbstractList | 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 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). 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. 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. 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. 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). 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. 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. 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. 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 BackgroundWe report follow-up data from an ongoing prospective cohort study of COVID-19 in pediatric kidney transplantation through the Improving Renal Outcomes Collaborative (IROC).MethodsPatient-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.ResultsFrom 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.ConclusionsDespite 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 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).BACKGROUNDWe report follow-up data from an ongoing prospective cohort study of COVID-19 in pediatric kidney transplantation through the Improving Renal Outcomes Collaborative (IROC).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.METHODSPatient-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.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.RESULTSFrom 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.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.CONCLUSIONSDespite 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. |
| Audience | Academic |
| Author | Ranabothu, Saritha Varnell, Charles Patel, Hiren P. Rodig, Nancy Brakeman, Paul Weng, Patricia L. Garro, Rouba Pruette, Cozumel Singer, Pamela Seifert, Michael E. Harshman, Lyndsay A. Smith, Laurie Gluck, Caroline Fadakar, Paul Sebestyen VanSickle, Judith Galea, Lauren Matossian, Debora Kershaw, David B. Hooper, David K. Barletta, Gina-Marie Al-Akash, Samhar Chaudhuri, Abanti Peterson, Caitlin Danziger-Isakov, Lara Liu, Chunyan |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35538239$$D View this record in MEDLINE/PubMed |
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| Copyright | The Author(s), under exclusive licence to International Pediatric Nephrology Association 2022 2022. The Author(s), under exclusive licence to International Pediatric Nephrology Association. COPYRIGHT 2023 Springer The Author(s), under exclusive licence to International Pediatric Nephrology Association 2022. |
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| PublicationSubtitle | Journal of the International Pediatric Nephrology Association |
| PublicationTitle | Pediatric nephrology (Berlin, West) |
| PublicationTitleAbbrev | Pediatr Nephrol |
| PublicationTitleAlternate | Pediatr Nephrol |
| PublicationYear | 2023 |
| Publisher | Springer Berlin Heidelberg Springer Springer Nature B.V |
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| References_xml | – volume: 69 start-page: 1410 year: 2020 end-page: 1415 ident: CR14 article-title: COVID-19 trends among school-aged children - United States, March 1–September 19, 2020 publication-title: Morb Mortal Wkly Rep doi: 10.15585/mmwr.mm6939e2 contributor: fullname: Lozier – volume: 21 start-page: 2740 year: 2021 end-page: 2748 ident: CR5 article-title: COVID-19 in pediatric kidney transplantation: the Improving Renal Outcomes Collaborative publication-title: Am J Transplant doi: 10.1111/ajt.16501 contributor: fullname: Seifert – volume: 42 start-page: 377 year: 2009 end-page: 381 ident: CR7 article-title: Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support publication-title: J Biomed Inform doi: 10.1016/j.jbi.2008.08.010 contributor: fullname: Conde – volume: 25 start-page: e13891 year: 2020 ident: CR6 article-title: Multicenter data to improve health for pediatric renal transplant recipients in North America: complementary approaches of NAPRTCS and IROC publication-title: Pediatr Transplant doi: 10.1111/petr.13891 contributor: fullname: Chua – volume: 135 start-page: 104715 year: 2021 ident: CR9 article-title: Prevalence, clinical characteristics, and outcomes of pediatric COVID-19: a systematic review and meta-analysis publication-title: J Clin Virol doi: 10.1016/j.jcv.2020.104715 contributor: fullname: Santana – ident: CR12 – ident: CR17 – volume: 25 start-page: e13868 year: 2020 ident: CR1 article-title: The pediatric solid organ transplant experience with COVID-19: an initial multi-center, multi-organ case series publication-title: Pediatr Transplant doi: 10.1111/petr.13868 contributor: fullname: Goss – volume: 41 start-page: 102573 year: 2020 ident: CR11 article-title: Pediatric COVID-19: systematic review of the literature publication-title: Am J Otolaryngol doi: 10.1016/j.amjoto.2020.102573 contributor: fullname: Patel – volume: 93 start-page: 1057 year: 2021 end-page: 1069 ident: CR13 article-title: A systematic review and meta-analysis of children with coronavirus disease 2019 (COVID-19) publication-title: J Med Virol doi: 10.1002/jmv.26398 contributor: fullname: Cai – volume: 181 start-page: 117 year: 2022 end-page: 123 ident: CR15 article-title: COVID-19 in pediatric patients undergoing chronic dialysis and kidney transplantation publication-title: Eur J Pediatr doi: 10.1007/s00431-021-04191-z contributor: fullname: Alpay – volume: 106 start-page: 798 year: 2020 end-page: 801 ident: CR2 article-title: COVID-19 in children treated with immunosuppressive medication for kidney diseases publication-title: Arch Dis Child doi: 10.1136/archdischild-2020-320616 contributor: fullname: Tullus – ident: CR8 – volume: 16 start-page: 449 year: 2021 end-page: 451 ident: CR3 article-title: Impact of COVID-19 pandemic in children with CKD or immunosuppression publication-title: Clin J Am Soc Nephrol doi: 10.2215/CJN.13120820 contributor: fullname: Montini – volume: 71 start-page: 2469 year: 2020 end-page: 2479 ident: CR10 article-title: SARS-CoV-2 (COVID-19): what do we know about children? 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Results from a single-center observational study publication-title: Clin Transplant doi: 10.1111/ctr.13889 contributor: fullname: Ghiggeri – volume: 385 start-page: 585 year: 2021 end-page: 594 ident: CR16 article-title: Effectiveness of COVID-19 vaccines against the B.1.617.2 (delta) variant publication-title: N Engl J Med doi: 10.1056/NEJMoa2108891 contributor: fullname: Ramsay – volume: 93 start-page: 1057 year: 2021 ident: 5570_CR13 publication-title: J Med Virol doi: 10.1002/jmv.26398 contributor: fullname: X Cui – volume: 34 start-page: e13889 year: 2020 ident: 5570_CR4 publication-title: Clin Transplant doi: 10.1111/ctr.13889 contributor: fullname: A Angeletti – volume: 21 start-page: 2740 year: 2021 ident: 5570_CR5 publication-title: Am J Transplant doi: 10.1111/ajt.16501 contributor: fullname: CD Varnell – volume: 71 start-page: 2469 year: 2020 ident: 5570_CR10 publication-title: Clin Infect Dis doi: 10.1093/cid/ciaa556 contributor: fullname: NS Mehta – volume: 41 start-page: 102573 year: 2020 ident: 5570_CR11 publication-title: Am J Otolaryngol doi: 10.1016/j.amjoto.2020.102573 contributor: fullname: NA Patel – volume: 42 start-page: 377 year: 2009 ident: 5570_CR7 publication-title: J Biomed Inform doi: 10.1016/j.jbi.2008.08.010 contributor: fullname: PA Harris – ident: 5570_CR8 – volume: 135 start-page: 104715 year: 2021 ident: 5570_CR9 publication-title: J Clin Virol doi: 10.1016/j.jcv.2020.104715 contributor: fullname: S Badal – volume: 25 start-page: e13891 year: 2020 ident: 5570_CR6 publication-title: Pediatr Transplant doi: 10.1111/petr.13891 contributor: fullname: DK Hooper – volume: 16 start-page: 449 year: 2021 ident: 5570_CR3 publication-title: Clin J Am Soc Nephrol doi: 10.2215/CJN.13120820 contributor: fullname: A Mastrangelo – volume: 385 start-page: 585 year: 2021 ident: 5570_CR16 publication-title: N Engl J Med doi: 10.1056/NEJMoa2108891 contributor: fullname: J Lopez Bernal – ident: 5570_CR12 doi: 10.1007/s00467-020-04597-1 – ident: 5570_CR17 – volume: 25 start-page: e13868 year: 2020 ident: 5570_CR1 publication-title: Pediatr Transplant doi: 10.1111/petr.13868 contributor: fullname: MB Goss – volume: 106 start-page: 798 year: 2020 ident: 5570_CR2 publication-title: Arch Dis Child doi: 10.1136/archdischild-2020-320616 contributor: fullname: M Marlais – volume: 69 start-page: 1410 year: 2020 ident: 5570_CR14 publication-title: Morb Mortal Wkly Rep doi: 10.15585/mmwr.mm6939e2 contributor: fullname: RT Leeb – volume: 181 start-page: 117 year: 2022 ident: 5570_CR15 publication-title: Eur J Pediatr doi: 10.1007/s00431-021-04191-z contributor: fullname: N Canpolat |
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We report follow-up data from an ongoing prospective cohort study of COVID-19 in pediatric kidney transplantation through the Improving Renal... We report follow-up data from an ongoing prospective cohort study of COVID-19 in pediatric kidney transplantation through the Improving Renal Outcomes... Background We report follow-up data from an ongoing prospective cohort study of COVID-19 in pediatric kidney transplantation through the Improving Renal... BackgroundWe report follow-up data from an ongoing prospective cohort study of COVID-19 in pediatric kidney transplantation through the Improving Renal... |
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| SubjectTerms | 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 |
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| Title | COVID-19 in pediatric kidney transplantation: a follow-up report of the Improving Renal Outcomes Collaborative |
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