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

• DOI: 10.1007/s00467-022-05570-w
• Publication Date: 2022-05-11T01:02:37Z
• Authors: Charles Varnell; Lyndsay A. Harshman; Chunyan Liu; Laurie Smith; Samhar Al-Akash; Gina-Marie Barletta; Paul Brakeman; Abanti Chaudhuri; Paul Fadakar; Lauren Galea; Rouba Garro; Caroline Gluck; David B. Kershaw; Debora Matossian; Hiren P. Patel; Caitlin Peterson; Cozumel Pruette; Saritha Ranabothu; Nancy Rodig; Pamela Singer; Judith Sebestyen ...; Patricia L. Weng; Lara Danziger-Isakov; Michael E. Seifert; David K. Hooper
• Keywords: Improving Renal Outcomes Collaborative; Kidney Disease; Clinical Sciences; Clinical Trials and Supportive Activities; Renal and urogenital; Clinical sciences; Paediatrics and Reproductive Medicine; 03 medical and health sciences; COVID-19 Testing; 0302 clinical medicine; Clinical Research; Humans; Prospective Studies; Aetiology; Kidney transplant; Child; Pediatric; Transplantation; Biomedical and Clinical Sciences; COVID-19; Paediatrics; Organ Transplantation; Urology & Nephrology; Kidney Transplantation; 3. Good health; Good Health and Well Being; Original Article; Patient Safety; 2.4 Surveillance and distribution; Follow-Up Studies

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.