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- Title
Outcomes and risk factors for death among hospitalized children and adolescents with kidney diseases and COVID-19: an analysis of a nationwide database.
- Authors
Vasconcelos, Mariana A.; Mendonça, Ana Carmen Q.; Colosimo, Enrico A.; Nourbakhsh, Noureddin; Martelli-Júnior, Hercílio; Silva, Ludmila R.; Oliveira, Maria Christina L.; Pinhati, Clara C.; Mak, Robert H.; Simões e Silva, Ana Cristina; Oliveira, Eduardo A.
- Abstract
Background: Patients with kidney diseases (KD) appear to be at particularly high risk for severe COVID-19. This study aimed to characterize the clinical outcomes and risk factors for COVID-19-related death in a large cohort of hospitalized pediatric patients with KD. Methods: We performed an analysis of all pediatric patients with KD and COVID-19 registered in SIVEP-Gripe, a Brazilian nationwide surveillance database, between February 16, 2020, and May 29, 2021. The primary outcome was time to death, which was evaluated considering discharge as a competitive risk by using cumulative incidence function. Results: Among 21,591 hospitalized patients with COVID-19, 290 cases (1.3%) had KD. Of these, 59 (20.8%) had a fatal outcome compared with 7.5% of the non-KD cohort (P < 0.001). Pediatric patients with KD had an increased hazard of death compared with the non-KD cohort (Hazard ratio [HR] = 2.85, 95% CI 2.21–3.68, P < 0.0001). After adjustment, the factors associated with the death among KD patients were living in Northeast (HR 2.16, 95% CI 1.13–4.31) or North regions (HR 3.50, 95% CI 1.57–7.80), oxygen saturation < 95% at presentation (HR 2.31, 95% CI 1.30–4.10), and presence of two or more associated comorbidities (HR 2.10, 95% CI 1.08–4.04). Conclusions: Children and adolescents with KD had a higher risk of death compared with the non-KD cohort. The higher risk was associated with low oxygen saturation at admission, living in socioeconomically disadvantaged regions, and presence of other pre-existing comorbidities. A higher resolution version of the Graphical abstract is available as Supplementary information
- Subjects
STATISTICAL significance; COVID-19; CONFIDENCE intervals; MULTIVARIATE analysis; RETROSPECTIVE studies; REGRESSION analysis; OXYGEN saturation; POPULATION geography; KIDNEY diseases; HOSPITAL care of teenagers; RISK assessment; SEX distribution; SURVIVAL analysis (Biometry); DESCRIPTIVE statistics; CHI-squared test; DATA analysis software; HOSPITAL care of children; LONGITUDINAL method; COMORBIDITY
- Publication
Pediatric Nephrology, 2023, Vol 38, Issue 1, p181
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-022-05588-0