Infectious Disease

The COVID-19 impact poses a low threat for kids with superior CRF, immunosuppression

December 21, 2020

1 min read

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Disclosure:
Mastrangelo reports that he is employed by the Ca’Granda Ospedale Maggiore Policlinico Milano Scientific Research and Care Institute. In the study you will find all relevant financial information from all other authors.

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Data from Italy show that the effects of COVID-19 in children with chronic kidney disease or immunosuppression are no greater when compared to a pediatric cohort who has neither condition.

“Italy was one of the countries hardest hit by the outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).” Antonio Mastrangelo, MD, the Department of Pediatric Nephrology, Dialysis and Transplantation at the Fondazione Istituto di Ricerca and Cura a Carattere Scientifico Ca’granda, Ospedale Maggiore Policlinico in Milan, and colleagues, wrote in a research letter. “Although adults with CKD and kidney transplant recipients are known to be at greater risk for disease severity due to immunosuppression and comorbidities, little is known about the corresponding pediatric population.”

Arm of child on hospital bed with teddy bear

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The researchers wrote that understanding how they might be affected by the virus is important as children with CKD or kidney replacement therapy are at increased risk of infection due to immunosuppression and exposure to dialysis units and hospital visits.

To do this, Mastrangelo and colleagues looked at data from a nationwide observational study conducted during the country’s embargo. They focused on patients younger than 18 years with either primary or secondary glomerulonephritis and idiopathic nephrotic syndrome who required long-term immunosuppressive therapy, CKD stages 3 to 5, dialysis, or kidney transplant (n = 1,572; mean age) . 11.1 years).

“The main objective was to identify patients with severe COVID-19, who are defined as follows: death, admission to the pediatric intensive care unit, mechanical ventilation, and the need to change ongoing immunosuppressive treatment based on a documented SARS-CoV-2 Infection, ”they wrote.

The results showed that COVID-19 posed a low risk for this patient population.

“No patient in our fragile population had severe COVID-19,” explained the researchers. “The absolute risk of SARS-CoV-2 infection was not significant, and the ratio of positive tests to performed tests is comparable to the general pediatric population.”

According to Mastrangelo and colleagues, the reason for the low incidence of the virus in the general pediatric population remains unclear.

These results show that even children at high risk (based on adult cohorts with similar characteristics) are at low risk for “clinically relevant COVID-19”.

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