COVID-19 in pediatric nephrology centers in Turkey

Authors: EMRE LEVENTOĞLU, YEŞİM ÖZDEMİR ATİKEL, HÜLYA NALÇACIOĞLU, İSMAİL DURSUN, HASAN DURSUN, ZEYNEP NAGEHAN YÜRÜK YILDIRIM, NURDAN YILDIZ, GÜLŞAH KAYA AKSOY, MEHMET TAŞDEMİR, MEHTAP ÇELAKIL, BELTİNGE DEMİRCİOĞLU KILIÇ, ŞENAY ZIRHLI SELÇUK, NUR CANPOLAT, EVRİM KARGIN ÇAKICI, SARE GÜLFEM ÖZLÜ, SEBAHAT TÜLPAR, SELÇUK YÜKSEL, BAHRİYE ATMIŞ, SERRA SÜRMELİ DÖVEN, SEVGİN TANER, PELİN ERTAN, ASLI KAVAZ TUFAN, MERAL TORUN BAYRAM, MUKADDES KALYONCU, KAAN SAVAŞ GÜLLEROĞLU, SÜLEYMAN CANER KABASAKAL, BELDE KASAP DEMİR, RUMEYSA YASEMİN ÇİÇEK GÜLŞAN, İLMAY BİLGE, OSMAN DÖNMEZ, ASLIHAN KARA, ÖNDER YAVAŞCAN, GÜL ÖZÇELİK, DENİZ GEZGİN YILDIRIM, MUHAMMET AKİF GÜLER, FERAH SÖNMEZ, MUAMMER HAKAN POYRAZOĞLU, SEMA AKMAN, REZAN TOPALOĞLU, HARİKA ALPAY, SEVCAN AZİME BAKKALOĞLU EZGÜ

Abstract: Background/aim: There is limited data on COVID-19 disease in children with kidney disease. We aimed to investigate the characteristics and prognosis of COVID-19 in pediatric nephrology patients in Turkey. Materials and methods: This was a national, multicenter, retrospective cohort study based on an online survey evaluating the data between 11th March 2020 and 11th March 2021 as an initial step of a detailed pediatric nephrology COVID-19 registry. Results: Two hundred and three patients (89 girls and 114 boys) were diagnosed with COVID-19. One-third of these patients (36.9%) were between 10-15 years old. Half of the patients were on kidney replacement therapy: kidney transplant (KTx) recipients (n = 56, 27.5%), patients receiving chronic hemodialysis (n = 33, 16.3%) and those on peritoneal dialysis (PD) (n = 18, 8.9%). Fifty-four (26.6%) children were asymptomatic. Eighty-two (40.3%) patients were hospitalized and 23 (28%) needed intensive care unit admission. Fiftyfive percent of the patients were not treated, while the remaining was given favipiravir (20.7%), steroid (16.3%), and hydroxychloroquine (11.3%). Acute kidney injury developed in 19.5% of hospitalized patients. Five (2.4%) had MIS-C. Eighty-three percent of the patients were discharged without any apparent sequelae, while 7 (3.4%) died. One hundred and eight health care staff were infected during the study period. Conclusion: COVID-19 was most commonly seen in patients who underwent KTx and received HD. The combined immunosuppressive therapy and frequent exposure to the hospital setting may increase these patients' susceptibility. Staff infections before vaccination era were alarming, various precautions should be taken for infection control, particularly optimal vaccination coverage.

Keywords: Children, COVID-19, kidney, pediatric nephrology, Turkey

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