Children with multisystem inflammation syndrome due to COVID-19 are at higher risk for AKI

March 16, 2021

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Basically reports on advice for Impact Communication Partners. In the study you will find all relevant financial information from all other authors.

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Pediatric patients with COVID-19 who also developed multisystem inflammatory syndrome in children were at greater risk for AKI and subsequent adverse outcomes, study results showed.

“The Sudden Rise of COVID-19 in Children and the Development of the Mysterious [multisystem inflammatory syndrome in children] MIS-C presented clinicians with a new challenge at the height of the pandemic, ”said the lead investigator Christine B. Sethna, MD, Associate professor at the Feinstein Institutes for Medical Research said in a related press release. “For frontline doctors and those who care for these children after they are released, it is important to understand the link between kidney injury and COVID-19 or MIS-C.”

The infographic content was adapted from Basalely A et al. Kidney int. 2021; doi: 10.1016 / j.kint.2021.02.026.

For the study, researchers included patients aged 18 years or younger who were hospitalized in one of four New York hospitals in the Northwell Health System between March and August 2020 (97 with acute COVID-19; 55 with MIS-C). MIS-C was determined using the CDC definition, which is presented here as “children with fever, significant signs of inflammation, signs of [at least two] Organ dysfunction and tested positive for current or recent SARS-CoV-2 infection or serological confirmation of exposure to COVID-19 within 4 weeks of symptoms appearing. ”

The researchers found that AKI occurred in 11.8% of all patients (8.2% of patients with COVID-19 versus 18.2% of patients with MIS-C); AKI was associated with lower serum albumin levels and higher white blood cells, “which may reflect the complex role the inflammatory cascade plays in the development and maintenance of AKI,” the researchers wrote.

Further results showed that patients with MIS-C developed a more severe AKI than patients with COVID-19 (for example, 1% of patients with COVID-19 had stage 3 AKI versus 7.3% with MIS-C).

Regarding the results in patients with AKI, the researchers found that patients with MIS-C had greater systolic dysfunction (80% versus 49%) and had hospital stays that were 8.4 days longer than patients with COVID-19 .

“The significant association of lower median left ventricular ejection fraction, systolic dysfunction, and AKI in MIS-C patients may suggest that low cardiac output also contributed to AKI,” the researchers wrote of the observed systolic dysfunction. “More importantly, not all patients with left ventricular dysfunction and / or shock in need of vasoactive agents developed AKI, suggesting multifactorial mechanisms of injury.”

Abby Basically, MD, The assistant professor at the Donald and Barbara Zucker School of Medicine at Hofstra / Northwell and the first author of the paper commented on the impact of the results in the press release.

“This research shows the risk of kidney injury, new clues about how COVID-19 progresses in children, and how we can ultimately manage the disease and its associated complications,” she said.

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