The impact of the COVID-19 pandemic on the incidence and clinical course of IgA vasculitis in paediatric patients

Abstract

Introduction and objective: Immunoglobulin A vasculitis is an autoimmune disorder resulting from immune complex accumulation in small blood vessels, causing skin, joint, abdominal, and kidney manifestations. This study evaluated the impact of the COVID-19 pandemic on the incidence and clinical course of immunoglobulin A vasculitis in paediatric patients. Materials and methods: A retrospective analysis of medical records from a single university paediatric hospital was performed to compare 117 patients presenting with immunoglobulin A vasculitis before and 57 after the COVID-19 epidemic announcement in Poland on 20 March 2020. Laboratory results, hospitalisation duration, preceding infections, clinical presentation, history of allergies and COVID-19 vaccinations, and the proportion of immunoglobulin A vasculitis patients among all admissions were analysed. Results: The study of 174 patients showed that their average age during the pandemic (5.51 ± 3.10) was significantly lower than pre-pandemically (6.98 ± 3.67) (p < 0.05). Before the pandemic, more hospitalised patients had immunoglobulin A vasculitis (1.14%) compared to during the pandemic (0.47%) (p < 0.05). Food allergies were also more common during the pandemic (20.8%) than before (8.8%) (p < 0.05). No significant differences were found in hospitalisation duration, and the incidence of immunoglobulin A vasculitis nephritis and abdominal symptoms (p = 0.194, p = 0.381, p = 0.968, respectively). Three patients had COVID-19 infection at admission. Conclusions: The pandemic led to fewer immunoglobulin A vasculitis hospitalisations but did not alter the clinical course of the disease or the incidence of immunoglobulin A vasculitis nephritis. In the context of the resurgence of COVID-19 infections, it is important to consider them as potential factors affecting immunoglobulin A vasculitis. Ongoing research is essential to understand these dynamics and guide effective clinical management of immunoglobulin A vasculitis amidst the evolving COVID-19 setting.