Rates of idiopathic childhood nephrotic syndrome relapse are lower during the COVID-19 pandemic

Crane, Clarkson; Bakhoum, Christine Y; Ingulli, Elizabeth

doi:10.1007/s00467-022-05483-8

Cited by 6 publications

(6 citation statements)

References 22 publications

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“…Surprisingly, we did not find a difference in incidence between the before and during pandemic INS cohorts in either region. This is in line with findings from Southern California where the number of new cases the year before the pandemic was similar to that of the first year of the pandemic [ 17 ]. No higher incidence during the repeated peaks or waves of Covid-19 related hospitalisations – and thus, SARS-CoV-2 burden – was observed.…”

Section: Discussionsupporting

confidence: 90%

“…During these periods of lockdown, study teams of the LEARNS (the Netherlands) and NEPHROVIR-3 (Paris area, France) trial noticed a decrease in the number of first onset INS, hypothesising that this may be due to less exposure to viral pathogens as a – desired – result of social distancing. This phenomenon has previously been suggested for relapse rate [ 17 – 19 ]. Therefore, the aim of this study is to compare the incidence of INS before (before March, 2020) and during (from March, 2020 to December, 2021) the Covid-19 pandemic in the Netherlands and the Paris area.…”

Section: Introductionmentioning

confidence: 52%

“…Two studies showed trends towards lower relapse rates of INS during the Covid-19 pandemic [ 18 , 19 ], while one did find a significant lower relapse rate [ 17 ]. We did not include relapse rate in our study, since a substantial proportion of children was included in one of the RCTs (either LEARNS or NEPHROVIR-3) which could have biased the results.…”

Section: Discussionmentioning

confidence: 99%

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Incidence of idiopathic nephrotic syndrome during the Covid-19 pandemic in the Paris area (France) and in the Netherlands

Veltkamp¹,

Thenot²,

Mussies³

et al. 2023

Pediatr Nephrol

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Background The aetiology of idiopathic nephrotic syndrome (INS) remains partially unknown. Viral infections have been associated with INS onset. Since we observed fewer first onset INS cases during the Covid-19 pandemic, we hypothesised that lower INS incidence was the result of lockdown measures. Therefore, the aim of this study was to evaluate the incidence of childhood INS before and during the COVID-19 pandemic in two independent European INS cohorts. Methods Children with new INS in the Netherlands (2018–2021) and Paris area (2018–2021) were included. We estimated incidences using census data for each region. Incidences were compared using two proportion Z-tests. Results A total of 128 and 324 cases of first onset INS were reported in the Netherlands and Paris area, respectively, corresponding to an annual incidence of 1.21 and 2.58 per 100,000 children/year. Boys and young children (< 7 years) were more frequently affected. Incidence before and during the pandemic did not differ. When schools were closed, incidence was lower in both regions: 0.53 vs. 1.31 (p = 0.017) in the Netherlands and 0.94 vs. 2.63 (p = 0.049) in the Paris area. During peaks of hospital admissions for Covid-19, no cases were reported in the Netherlands or Paris area. Conclusions Incidence of INS before and during the Covid-19 pandemic was not different, but when schools were closed during lockdown, incidence was significantly lower. Interestingly, incidences of other respiratory viral infections were also reduced as was air pollution. Together, these results argue for a link between INS onset and viral infections and/or environmental factors. Graphical abstract

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

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Incidence of idiopathic nephrotic syndrome during the Covid-19 pandemic in the Paris area (France) and in the Netherlands

Veltkamp¹,

Thenot²,

Mussies³

et al. 2023

Pediatr Nephrol

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“…[39][40][41][42] Additionally, observational studies reported reductions in the incidence and relapse of the nephrotic and nephritic syndrome amongst children. 43,44 The reasons behind the decrease in glucosuria remain largely unknown; however, changes in adiposity status may not be attributed to this decrease because the incidence rate of diabetes mellitus amongst Japanese children is very low, at 2-3 cases per 100 000 person-years, 45 making it improbable to be reflected in the current data. Alternatively, an increase in the consumption of instant and processed foods during the COVID-19 pandemic might explain the reduction in glucosuria amongst children.…”

Section: Discussionmentioning

confidence: 89%

Impact of COVID‐19 pandemic on physical health amongst children: Difference‐in‐differences analyses of nationwide school health checkup database

Okubo,

Ishitsuka,

Goto

2024

Pediatric Obesity

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SummaryIntroductionThe COVID‐19 pandemic posed tremendous challenges for children. However, the long‐term effects of the pandemic on various aspects of physical health at a national level remain unclear.MethodsIn this retrospective cohort study, we analysed data from nationwide health checkup records amongst children aged 7–15 years. The dataset comprised 3 544 146 records from 393 794 individuals who graduated from junior high school during fiscal years 2007 to 2022. Difference‐in‐differences (DID) analyses with multiple time periods were used to examine the impact of COVID‐19 on physical health outcomes.ResultsCompared with the pre‐pandemic period, the COVID‐19 pandemic was associated with excess increases in obesity for boys and girls, persisting over the 3 years (+0.42%; [95% CI, 0.23–0.61]). Also, it was associated with excess increases in underweight (+0.28% [0.25–0.32]) and poor visual acuity amongst boys in the 3rd year (+1.80% [1.30–2.30]). There were excess reductions in dental caries (−1.48% [−2.01 to −0.95]), glucosuria (−0.55 [−0.88 to −0.23]) and hematuria (−0.43% [−0.73 to −0.13]) during the 3rd year of the pandemic.ConclusionsThese findings underscore the multifaceted impact of the pandemic on various health indicators for school‐aged children. This information could be valuable for public health policy and paediatric healthcare planning in the post‐pandemic era.

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“…These results are in line with the data presented by Harambat et al [ 20 ], who did not find any increase in the relapse rate during the first COVID-19 wave in a cohort of 111 INS children, when compared to the same period of the previous year [ 20 ]. Furthermore, Crane et al reported a statistically significant lower relapse rate during the pandemic as compared to the previous 5 years, speculating that this difference could be related to the decreased rates of viral infections [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Relapse rate in children with nephrotic syndrome during the SARS-CoV-2 pandemic

et al. 2022

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Background Viral upper respiratory tract infections trigger nephrotic syndrome relapses. Few data exist on the impact of the SARS-CoV-2 pandemic on the risk of relapse in children with idiopathic nephrotic syndrome (INS). Methods In a Belgian and Italian cohort of children with INS, we performed a retrospective analysis on the number and duration of relapses observed in 3 different periods in 2020: first COVID period, February 15–May 31; second COVID period, June 1–September 14; third COVID period, September 15–December 31. Relapse rates were compared to those of the previous 5 years (PRECOVID period). For the years 2019 and 2020, all causes and INS relapse-related hospitalizations were recorded. Hospitalizations and deaths due to SARS-CoV-2 infection were also recorded. In the Belgian cohort, SARS-CoV-2 serologies were performed. Results A total of 218 patients were enrolled, and 29 (13.3%) were diagnosed with new-onset INS during the COVID period. Relapse rates per 1000 person-days were as follows: 3.2 in the PRECOVID period, 2.7 in the first COVID period, 3.3 in the second COVID period, and 3.0 in the third COVID period. The incidence rate ratio for the total COVID period was 0.9 (95%CI 0.76 to 1.06; P = 0.21) as compared to the PRECOVID period. During 2020, both the proportion of patients hospitalized for recurrence (14.2% vs. 7.6% in 2019; P = 0.03) and the rate of hospitalization for recurrence (IRR 1.97 (95%CI 1.35 to 2.88); P = 0.013) were higher compared to 2019. In December 2020, anti-SARS-CoV-2 antibodies were detected in 31% of the Belgian cohort. Patients with positive and negative SARS-CoV-2 serology did not differ significantly in relapse rate (2.4 versus 4.2 per 1000 person-days). The number of new INS cases remained similar between 2020, 2019, and 2018. Conclusion The first year of the SARS-CoV-2 pandemic did not significantly affect the relapse rate in children with INS. No serious infections were reported in this population of immunosuppressed patients. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information Supplementary Information The online version contains supplementary material available at 10.1007/s00467-022-05702-2.

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Rates of idiopathic childhood nephrotic syndrome relapse are lower during the COVID-19 pandemic

Cited by 6 publications

References 22 publications

Incidence of idiopathic nephrotic syndrome during the Covid-19 pandemic in the Paris area (France) and in the Netherlands

Incidence of idiopathic nephrotic syndrome during the Covid-19 pandemic in the Paris area (France) and in the Netherlands

Impact of COVID‐19 pandemic on physical health amongst children: Difference‐in‐differences analyses of nationwide school health checkup database

Relapse rate in children with nephrotic syndrome during the SARS-CoV-2 pandemic

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