Year: 2020
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Children are recognised as at lower risk of severe COVID-19 compared with adults, but the impact of immunosuppression is yet to be determined. This study aims to describe the clinical course of COVID-19 in children with kidney disease taking immunosuppressive medication and to assess disease severity. METHODS: Cross-sectional study hosted by the European Rare Kidney Disease Reference Network and supported by the European, Asian and International paediatric nephrology societies. Anonymised data were submitted online for any child (age <20 years) with COVID-19 taking immunosuppressive medication for a kidney condition. Study recruited for 16 weeks from 15 March 2020 to 05 July 2020. The primary outcome was severity of COVID-19. RESULTS: 113 children were reported in this study from 30 different countries. Median age: 13 years (49% male). Main underlying reasons for immunosuppressive therapy: kidney transplant (47%), nephrotic syndrome (27%), systemic lupus erythematosus (10%). Immunosuppressive medications used include: glucocorticoids (76%), mycophenolate mofetil (MMF) (54%), tacrolimus/ciclosporine A (58%), rituximab/ofatumumab (11%). 78% required no respiratory support during COVID-19 illness, 5% required bi-level positive airway pressure or ventilation. Four children died; all deaths reported were from low-income countries with associated comorbidities. There was no significant difference in severity of COVID-19 based on gender, dialysis status, underlying kidney condition, and type or number of immunosuppressive medications. CONCLUSIONS: This global study shows most children with a kidney disease taking immunosuppressive medication have mild disease with SARS-CoV-2 infection. We therefore suggest that children on immunosuppressive therapy should not be more strictly isolated than children who are not on immunosuppressive therapy.
Source: Archives of Disease in Childhood
Authors: Matko Marlais, Tanja Wlodkowski, Samhar Al-Akash, Petr Ananin, Varun Kumar Bandi, Veronique Baudouin, Olivia Boyer, Luciola Vásquez, Sukanya Govindan, Nakysa Hooman, Iftikhar Ijaz, Reyner Loza, Marta Melgosa, Nivedita Pande, Lars Pape, Anshuman Saha, Dmitry Samsonov, Michiel F Schreuder, Jyoti Sharma, Sahar Siddiqui, Rajiv Sinha, Heather Stewart, Velibor Tasic, Burkhard Tönshoff, Katherine Twombley, Kiran Upadhyay, Marina Vivarelli, Donald J Weaver, Robert Woroniecki, Franz Schaefer, Kjell Tullus
Institutions: National Health Service, Great Ormond Street Hospital, Great Ormond Street Hospital for Children NHS Foundation Trust, University College London, Heidelberg University, University Hospital Heidelberg, Driscoll Children's Hospital, Scientific Center of Children's Health, Assistance Publique – Hôpitaux de Paris, Hôpital Robert-Debré, Hôpital Necker-Enfants Malades, Inserm, Université Paris Cité, Institut des Maladies Génétiques Imagine, Hospital Base Guillermo Almenara Irigoyen, Dr. Mehta's Children's Hospital, Iran University of Medical Sciences, King Edward Medical University, Mayo Hospital, Hospital Nacional Cayetano Heredia, Hospital Universitario La Paz, Topiwala National Medical College & BYL Nair Charitable Hospital, Essen University Hospital, Institute of Transplantation Sciences, New York Medical College, Radboud University Medical Center, Amalia Kinderziekenhuis, King Edward Memorial Hospital Research Centre, Baylor College of Medicine, Texas Children's Hospital, Institute of Child Health, Medical University of South Carolina, University of Florida, Bambino Gesù Children's Hospital, Istituti di Ricovero e Cura a Carattere Scientifico, Levine Children's Hospital, Stony Brook Children's Hospital
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Awards: G2660646404, G6533600717
OpenAlex ID: W3106976909