tetano
Editor, Senior Moderator
Pediatr Nephrol
. 2023 May 12.
doi: 10.1007/s00467-023-05987-x. Online ahead of print. Acute kidney injury in critically ill children with COVID-19 and MIS-C
Hasan Özen[SUP] 1 [/SUP], Ayşen Durak Aslan[SUP] 2 [/SUP], Burak Balaban[SUP] 3 [/SUP], Oktay Perk[SUP] 4 [/SUP], Hacer Uçmak[SUP] 3 [/SUP], Serhan Özcan[SUP] 4 [/SUP], Anar Gurbanov[SUP] 3 [/SUP], Emel Uyar[SUP] 4 [/SUP], Fevzi Kahveci[SUP] 3 [/SUP], Emrah Gün[SUP] 3 [/SUP], Ali Kansu Tehci[SUP] 5 [/SUP], Serhat Emeksiz[SUP] 4 [/SUP], Tanıl Kendirli[SUP] 3 [/SUP]
Affiliations
Background: This study's objective was to investigate the incidence of acute kidney injury (AKI) in children with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and multisystem inflammatory syndrome (MIS-C) and to report our clinical experience.
Methods: Acute COVID-19 and MIS-C-diagnosed patients observed in two pediatric intensive care units (PICUs) between 2019 and 2021 were examined for AKI and retrospectively compared to children with AKI.
Results: The study comprised 163 children, of whom 98 (60.1%) were diagnosed with acute COVID-19 and 65 (39.9%) with MIS-C. AKI was observed in 40 (40.8%) of the acute COVID-19 patients and 18 (27.7%) of the MIS-C patients. Low calcium level and hypotension were linked with AKI at initial presentation (OR: 0.56, 95% CI: 0.369-0.560, p = 0.006 and OR: 3.64, 95% CI: 1.885-7.152, p = 0.001, respectively). A history of nephrotoxic medication usage played an essential role in the development of AKI in patients who acquired AKI after hospitalization (p = 0.001, odds ratio: 9.32, confidence interval: 3.106-27.973). In clinical practice, individuals with respiratory distress and cough had a high chance of having AKI (OR: 4.47, 95% confidence interval: 2.25-8,892 and OR: 3.48, 95% confidence interval: 1.76-6.88). AKI patients had a greater demand for respiratory assistance and a longer period of stay in the PICU.
Conclusions: AKI in the COVID-19 and MIS-C patient groups is related with increased mortality and extended hospitalization, according to the findings. These statistics imply that identifying and preventing risk factors is necessary. A higher resolution version of the Graphical abstract is available as Supplementary information.
Keywords: Acute kidney injury; Multisystem inflammatory syndrome; Pediatric intensive care; SARS-CoV-2.
. 2023 May 12.
doi: 10.1007/s00467-023-05987-x. Online ahead of print. Acute kidney injury in critically ill children with COVID-19 and MIS-C
Hasan Özen[SUP] 1 [/SUP], Ayşen Durak Aslan[SUP] 2 [/SUP], Burak Balaban[SUP] 3 [/SUP], Oktay Perk[SUP] 4 [/SUP], Hacer Uçmak[SUP] 3 [/SUP], Serhan Özcan[SUP] 4 [/SUP], Anar Gurbanov[SUP] 3 [/SUP], Emel Uyar[SUP] 4 [/SUP], Fevzi Kahveci[SUP] 3 [/SUP], Emrah Gün[SUP] 3 [/SUP], Ali Kansu Tehci[SUP] 5 [/SUP], Serhat Emeksiz[SUP] 4 [/SUP], Tanıl Kendirli[SUP] 3 [/SUP]
Affiliations
- PMID: 37171582
- DOI: 10.1007/s00467-023-05987-x
Background: This study's objective was to investigate the incidence of acute kidney injury (AKI) in children with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and multisystem inflammatory syndrome (MIS-C) and to report our clinical experience.
Methods: Acute COVID-19 and MIS-C-diagnosed patients observed in two pediatric intensive care units (PICUs) between 2019 and 2021 were examined for AKI and retrospectively compared to children with AKI.
Results: The study comprised 163 children, of whom 98 (60.1%) were diagnosed with acute COVID-19 and 65 (39.9%) with MIS-C. AKI was observed in 40 (40.8%) of the acute COVID-19 patients and 18 (27.7%) of the MIS-C patients. Low calcium level and hypotension were linked with AKI at initial presentation (OR: 0.56, 95% CI: 0.369-0.560, p = 0.006 and OR: 3.64, 95% CI: 1.885-7.152, p = 0.001, respectively). A history of nephrotoxic medication usage played an essential role in the development of AKI in patients who acquired AKI after hospitalization (p = 0.001, odds ratio: 9.32, confidence interval: 3.106-27.973). In clinical practice, individuals with respiratory distress and cough had a high chance of having AKI (OR: 4.47, 95% confidence interval: 2.25-8,892 and OR: 3.48, 95% confidence interval: 1.76-6.88). AKI patients had a greater demand for respiratory assistance and a longer period of stay in the PICU.
Conclusions: AKI in the COVID-19 and MIS-C patient groups is related with increased mortality and extended hospitalization, according to the findings. These statistics imply that identifying and preventing risk factors is necessary. A higher resolution version of the Graphical abstract is available as Supplementary information.
Keywords: Acute kidney injury; Multisystem inflammatory syndrome; Pediatric intensive care; SARS-CoV-2.