Renal Complications Due to SARS-CoV-2 Infection in Pediatric Population

COVID-19 pandemic originated in Wuhan City, China, in 2019. The disease spectrum ranges from asymptomatic to severe respiratory failure leading to death. Although in a lower percentage, pediatric patients also have complications, not only pulmonary but also systemic, affecting other organs. This article aims to study the renal involvement of pediatric patients infected by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2).

We designed a retrospective observational cohort study of patients hospitalized in the emergency department and intensive care unit of a tertiary medical facility hospital Infantil de México Federico Gomez in Mexico City, from March 1, 2020, to May 16, 2021. The inclusion criteria included patients younger than 18 years who had a positive Reverse Transcription-Polymerase Chain Reaction (RT-PCR) test or a positive rapid antigen test of nasopharyngeal sample for SARS-CoV-2 at admission.

We included 165 patients, of whom 29(17.6%) patients developed renal complications during hospitalization. In these patients, 12(41.3%) patients developed proteinuria, 10(34.5%) developed any type of Acute Kidney Injury (AKI), i.e., Acute Kidney Injury Network (AKIN-1) in 26.6%, AKIN-2 in 40% and AKIN-3 in 33.3%. Also, 5(17.2%) patients had arterial hypertension, 2(6.9%) required renal replacement therapy, 4(13.8%) had hematuria. Only 1(3.4%) patient had developed rapidly progressive glomerulonephritis.

COVID-19 infection within its spectrum can cause kidney disease; the most common complications are proteinuria and AKI. Older age and admission to the intensive care unit are risk factors for kidney damage.