Acute kidney injury in children with moderate-severe COVID-19 and multisystem inflammatory syndrome in children: a referral center experience.
Autor: | Tastemel Ozturk, Tugba, Düzova, Ali, Oygar, Pembe Derin, Baltu, Demet, Ozcilingir Hakverdi, Pelin, Lacinel Gurlevik, Sibel, Kurt-Sukur, Eda Didem, Aykan, Hayrettin Hakan, Ozen, Seza, Ertugrul, Ilker, Kesici, Selman, Gulhan, Bora, Ozaltin, Fatih, Ozsurekci, Yasemin, Cengiz, Ali Bulent, Topaloglu, Rezan |
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Předmět: |
LENGTH of stay in hospitals
VASOCONSTRICTORS COVID-19 MULTISYSTEM inflammatory syndrome CHILDREN'S hospitals MULTIVARIATE analysis INFLAMMATION TERTIARY care PEDIATRICS CARDIOVASCULAR diseases SEVERITY of illness index RISK assessment COMPARATIVE studies SYMPTOMS HOSPITAL care DESCRIPTIVE statistics ODDS ratio ACUTE kidney failure LYMPHOCYTE count CARDIOTONIC agents DISEASE risk factors DISEASE complications CHILDREN |
Zdroj: | Pediatric Nephrology; Mar2024, Vol. 39 Issue 3, p867-877, 11p |
Abstrakt: | Background: Data on the characteristics of acute kidney injury (AKI) in pediatric COVID-19 and MIS-C are limited. We aimed to define the frequency, associated factors and early outcome of AKI in moderate, severe or critical COVID-19 and MIS-C; and to present a tertiary referral center experience from Türkiye. Methods: Hospitalized patients ≤ 18 years of age with confirmed COVID-19 or MIS-C at İhsan Doğramacı Children's Hospital, Hacettepe University, between March 2020—December 2021 were enrolled. The characteristics of AKI in the COVID-19 group were investigated in moderate, severe and critically ill patients; patients with mild COVID-19 were excluded. Results: The median (Q1-Q3) age in the COVID-19 (n = 66) and MIS-C (n = 111) groups was 10.7 years (3.9–15.2) and 8.7 years (4.5–12.7), respectively. The frequency of AKI was 22.7% (15/66) in COVID-19 and 15.3% (17/111) in MIS-C; all MIS-C patients with AKI and 73.3% (11/15) of COVID-19 patients with AKI had AKI at the time of admission. Multivariate analyses revealed need for vasoactive/inotropic agents [Odds ratio (OR) 19.233, p = 0.002] and presence of vomiting and/or diarrhea (OR 4.465, p = 0.036) as independent risk factors of AKI in COVID-19 patients; and need for vasoactive/inotropic agents (OR 22.542, p = 0.020), procalcitonin and ferritin levels as independent risk factors of AKI in the MIS-C group. Age was correlated with lymphocyte count (r = -0.513, p < 0.001) and troponin level (r = 0.518, p < 0.001) in MIS-C patients. Length of hospital stay was significantly longer in both groups with AKI, compared to those without AKI. Mortality was 9.1% in the COVID-19 group; and was associated with AKI (p = 0.021). There was no mortality in MIS-C patients. AKI recovery at discharge was 63.6% in COVID-19 survivors and 100% in MIS-C patients. Conclusions: Independent risk factors for AKI were need for vasoactive/inotropic agents and vomiting/diarrhea in moderate, severe or critical COVID-19 patients; and need for vasoactive/inotropic agents and severe inflammation in MIS-C patients. Our findings suggest that inflammation and cardiac dysfunction are associated with AKI in MIS-C patients; and the association with age in this group merits further studies in larger groups. Early outcome is favorable; long-term follow-up for kidney functions is needed. [ABSTRACT FROM AUTHOR] |
Databáze: | Complementary Index |
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