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- Title
COVID-19 in pediatric kidney transplantation: a follow-up report of the Improving Renal Outcomes Collaborative.
- Authors
Varnell Jr., Charles; Harshman, Lyndsay A.; Liu, Chunyan; Smith, Laurie; Al-Akash, Samhar; Barletta, Gina-Marie; Brakeman, Paul; Chaudhuri, Abanti; Fadakar, Paul; Galea, Lauren; Garro, Rouba; Gluck, Caroline; Kershaw, David B.; Matossian, Debora; Patel, Hiren P.; Peterson, Caitlin; Pruette, Cozumel; Ranabothu, Saritha; Rodig, Nancy; Singer, Pamela
- Abstract
Background: We report follow-up data from an ongoing prospective cohort study of COVID-19 in pediatric kidney transplantation through the Improving Renal Outcomes Collaborative (IROC). Methods: Patient-level data from the IROC registry were combined with testing, indication, and outcomes data collected to describe the epidemiology of COVID testing, treatment, and clinical outcomes; determine the incidence of a positive COVID-19 test; describe rates of COVID-19 testing; and assess for clinical predictors of a positive COVID-19 test. Results: From September 2020 to February 2021, 21 centers that care for 2690 patients submitted data from 648 COVID-19 tests on 465 patients. Most patients required supportive care only and were treated as outpatients, 16% experienced inpatient care, and 5% experienced intensive care. Allograft complications were rare, with acute kidney injury most common (7%). There was 1 case of respiratory failure and 1 death attributed to COVID-19. Twelve centers that care for 1730 patients submitted complete testing data on 351 patients. The incidence of COVID-19 among patients at these centers was 4%, whereas the incidence among tested patients was 19%. Risk factors to predict a positive COVID-19 test included age > 12 years, symptoms consistent with COVID-19, and close contact with a confirmed case of COVID-19. Conclusions: Despite the increase in testing and positive tests over this study period, the incidence of allograft loss or death related to COVID-19 remained extremely low, with allograft loss or death each occurring in < 1% of COVID-19-positive patients and in less than < 0.1% of all transplant patients within the IROC cohort. A higher resolution version of the Graphical abstract is available as Supplementary information
- Subjects
EVALUATION of medical care; COVID-19; HOMOGRAFTS; KIDNEY transplantation; DISEASE incidence; DESCRIPTIVE statistics; COVID-19 testing; RECEIVER operating characteristic curves; SENSITIVITY &; specificity (Statistics); DATA analysis software; LONGITUDINAL method; EVALUATION
- Publication
Pediatric Nephrology, 2023, Vol 38, Issue 2, p537
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-022-05570-w