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

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

Charles Varnell, Lyndsay A Harshman, Chunyan Liu, Laurie Smith, Samhar Al-Akash, Gina-Marie Barletta, Paul Brakeman, Abanti Chaudhuri, Paul Fadakar, Lauren Galea, …
Pediatric Nephrology, Vol.38(2), pp.537-547
02/01/2023
DOI: 10.1007/s00467-022-05570-w
PMCID: PMC9090538
PMID: 35538239
url
https://doi.org/10.1007/s00467-022-05570-wView
Published (Version of record) Open Access

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
 Organ Transplantation Patient Safety 2.4 Surveillance and distribution Aetiology Biomedical and Clinical Sciences Child Clinical Research Clinical Sciences Clinical Trials and Supportive Activities COVID-19 COVID-19 Testing Follow-Up Studies Good Health and Well Being Humans Improving Renal Outcomes Collaborative Kidney Disease Kidney transplant Kidney Transplantation Paediatrics Paediatrics and Reproductive Medicine Pediatric Prospective Studies Renal and urogenital Transplantation Urology & Nephrology

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