COVID-19 in pediatric kidney transplantation: a follow-up report of the Improving Renal Outcomes Collaborative

Charles Varnell, Lyndsay A. Harshman, Chunyan Liu, Laurie Smith, Samhar Al-Akash, Gina Marie Barletta, Paul Brakeman, Abanti Chaudhuri, Paul Fadakar, Lauren Galea, Rouba Garro, Caroline Gluck, David B. Kershaw, Debora Matossian, Hiren P. Patel, Caitlin Peterson, Cozumel Pruette, Saritha Ranabothu, Nancy Rodig, Pamela SingerJudith Sebestyen VanSickle, Patricia L. Weng, Lara Danziger-Isakov, Michael E. Seifert, David K. Hooper

Research output: Contribution to journalArticlepeer-review

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. Graphical abstract: A higher resolution version of the Graphical abstract is available as Supplementary information [Figure not available: see fulltext.].

Original languageEnglish (US)
Pages (from-to)537-547
Number of pages11
JournalPediatric Nephrology
Volume38
Issue number2
DOIs
StatePublished - Feb 2023

Keywords

  • COVID-19
  • Improving Renal Outcomes Collaborative
  • Kidney transplant

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

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