COVID-19 in pediatric kidney transplantation: The Improving Renal Outcomes Collaborative |
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| Authors: | Charles Varnell Jr Lyndsay A Harshman Laurie Smith Chunyan Liu Shiran Chen Samhar Al-Akash Gina-Marie Barletta Craig Belsha Paul Brakeman Abanti Chaudhuri Paul Fadakar Rouba Garro Caroline Gluck Jens Goebel David Kershaw Debora Matossian Corina Nailescu Hiren P Patel Cozumel Pruette Saritha Ranabothu Nancy Rodig Jodi Smith Judith Sebestyen VanSickle Patricia Weng Lara Danziger-Isakov David K Hooper Michael Seifert |
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| Institution: | 1. Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio;2. University of Iowa Stead Family Children’s Hospital, Iowa City, Iowa;3. Driscoll Children’s Hospital, Corpus Christi, Texas;4. Phoenix Children’s Hospital, University of Arizona, Phoenix, Arizona;5. SSM Health Cardinal Glennon Children's Hospital, Saint Louis, Missouri;6. Department of Pediatrics, University of California, San Francisco, California;7. Lucile Packard Children’s Hospital, Stanford University, Stanford, California;8. UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania;9. Children’s Healthcare of Atlanta, Emory School of Medicine, Atlanta, Georgia;10. Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware;11. Children’s Hospital Colorado, Aurora, Colorado;12. C.S. Mott Children’s Hospital, Ann Arbor, Michigan;13. Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois;14. Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana;15. Nationwide Children’s Hospital, Columbus, Ohio;16. Johns Hopkins University School of Medicine, Baltimore, Maryland;17. Arkansas Children’s Hospital, Little Rock, Arkansas;18. Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts;19. Seattle Children’s Hospital, Seattle, Washington;20. Children’s Mercy Kansas City, Kansas City, Missouri;21. UCLA Mattel Children’s Hospital, Los Angeles, California;22. University of Alabama at Birmingham, Children’s of Alabama, Birmingham, Alabama |
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| Abstract: | There are limited data on the impact of COVID-19 in children with a kidney transplant (KT). We conducted a prospective cohort study through the Improving Renal Outcomes Collaborative (IROC) to collect clinical outcome data about COVID-19 in pediatric KT patients. Twenty-two IROC centers that care for 2732 patients submitted testing and outcomes data for 281 patients tested for SARS-CoV-2 by PCR. Testing indications included symptoms and/or potential exposures to COVID-19 (N = 134, 47.7%) and/or testing per hospital policy (N = 154, 54.8%). Overall, 24 (8.5%) patients tested positive, of which 15 (63%) were symptomatic. Of the COVID-19-positive patients, 16 were managed as outpatients, six received non-ICU inpatient care and two were admitted to the ICU. There were no episodes of respiratory failure, allograft loss, or death associated with COVID-19. To estimate incidence, subanalysis was performed for 13 centers that care for 1686 patients that submitted all negative and positive COVID-19 results. Of the 229 tested patients at these 13 centers, 10 (5 asymptomatic) patients tested positive, yielding an overall incidence of 0.6% and an incidence among tested patients of 4.4%. Pediatric KT patients in the United States had a low estimated incidence of COVID-19 disease and excellent short-term outcomes. |
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| Keywords: | clinical research/practice epidemiology health services and outcomes research infection and infectious agents infectious disease kidney transplantation/nephrology pediatrics |
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