COVID-19 in Children with Chronic Dialysis and Kidney Transplantation

Abstract

The aim of the study is to present incidence of COVID-19 in children with renal replacement therapy (RRT) and compare the severity and outcomes of the disease between the groups undergoing dialysis and kidney transplantation (KTx). This multicenter observational study was based on data collected from children receiving RRT, either chronic dialysis or KTx, diagnosed with COVID-19. All members of the Istanbul branch of the Turkish Pediatric Nephrology Association were requested to submit all their confirmed COVID-19 cases between April 1 and December 31, 2020. They were also asked to report the number of their prevalent patients on RRT under the age of 20. A total of 46 RRT patients diagnosed with COVID-19 were reported from 12 centers. Of these, 29 were KTx recipients, and 17 were on dialysis. COVID-19 cases represented 9.3% of all prevalent dialysis patients and 9.2% of all prevalent KTx recipients. Twelve KTx recipients (41.4%) and three dialysis patients (17.6%) were asymptomatic (p = 0.12). The hospitalization rate was higher in dialysis patients than KTx recipients (82.4% vs. 27.6%, p = 0.001). Two patients, one in each group, experienced a severe disease course, and only one hemodialysis patient had a critical illness that required mechanical ventilation. Acute kidney injury developed in 36% of KTx recipients, but none required dialysis or lost their graft. In the entire cohort, one patient on hemodialysis with multiple comorbidities died.Conclusion: Although most of cases were asymptomatic or had a mild disease, children on RRT seem to have an increased risk for COVID-19.