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Renal Involvement in Hospitalized Children with COVID-19

Received: 6 June 2023    Accepted: 21 June 2023    Published: 8 July 2023
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Abstract

Background: Coronavirus disease 2019 (COVID-19), usually causes respiratory and gastrointestinal symptoms in children. While the clinical features range from upper respiratory tract infections to severe diseases. Kidney involvement in these children has been reported in different parts of the world, with different prevalence and acuity. To date, data are still accumulating to characterize kidney involvement in this disease and its impact on these children. Objective: We aimed to determine the prevalence of renal involvement in hospitalized children with COVID-19 in the state of Qatar and describe their clinical presentation and outcome. Methods: We retrospectively reviewed all children (age 0–14 years) with COVID-19 admitted to Hamad General Hospital, from March 1, 2020, to January 1, 2021. The diagnosis was confirmed by positive PCR results for the virus. We reviewed kidney involvement in these children at presentation, during hospitalization, and at 6 weeks follow-up. Results: A total of 2586 patients who were positive by PCR were reviewed, of which 584 were excluded due to missing data, and 1602 were completely asymptomatic at presentation. A total of 400 patients were then included in this study and were divided into two groups: patients without renal involvement (non-renal group) 282 patients (70.5%), and patients with renal involvement (renal group) 118 patients (29.5%). In the renal group, the median age was 16.7 months, and 90 patients (76.3%) were female. Fever was present in 107 patients (90.7%), and the median duration of hospitalization was 3.3 days. In this group, 84 patients (71.2%) presented with respiratory symptoms, and 34 patients (28.8%) presented with gastroenterological symptoms. The most frequent manifestation of renal involvement in these patients was microscopic hematuria, followed by leukocyturia, and acute kidney injury (AKI) was present in 14 patients (12%). During the reported period and follow-up of 6 weeks, children with AKI were at an early stage, and none of them required kidney replacement therapy. Conclusion: Kidney involvement in children with COVID-19 infection in our patients was noted in almost one-third of the patients and varied from urinary findings without any clinical symptoms to early-stage AKI. Electrolyte abnormalities with metabolic acidosis can present at presentation and require careful attention and management.

Published in American Journal of Pediatrics (Volume 9, Issue 3)
DOI 10.11648/j.ajp.20230903.11
Page(s) 104-113
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Coronavirus Disease 2019 (COVID-19), Acute Kidney Injury (AKI), Urinary Tract Infections (UTIs)

References
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Cite This Article
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    Mahmoud Alhandi Omar Helal, Abubakr Imam, Shaikha Nasser Al-Thani, Wadha Al-Shafi, Lujain Loay, et al. (2023). Renal Involvement in Hospitalized Children with COVID-19. American Journal of Pediatrics, 9(3), 104-113. https://doi.org/10.11648/j.ajp.20230903.11

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    ACS Style

    Mahmoud Alhandi Omar Helal; Abubakr Imam; Shaikha Nasser Al-Thani; Wadha Al-Shafi; Lujain Loay, et al. Renal Involvement in Hospitalized Children with COVID-19. Am. J. Pediatr. 2023, 9(3), 104-113. doi: 10.11648/j.ajp.20230903.11

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    AMA Style

    Mahmoud Alhandi Omar Helal, Abubakr Imam, Shaikha Nasser Al-Thani, Wadha Al-Shafi, Lujain Loay, et al. Renal Involvement in Hospitalized Children with COVID-19. Am J Pediatr. 2023;9(3):104-113. doi: 10.11648/j.ajp.20230903.11

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  • @article{10.11648/j.ajp.20230903.11,
      author = {Mahmoud Alhandi Omar Helal and Abubakr Imam and Shaikha Nasser Al-Thani and Wadha Al-Shafi and Lujain Loay and Farid Fatnassi and Mahmoud Abdul Majid and Malek Almoustafa and Fatin A. Moussa and Mohammed Sultan and Moustafa Ezz and Limia Altaj Sati Seed},
      title = {Renal Involvement in Hospitalized Children with COVID-19},
      journal = {American Journal of Pediatrics},
      volume = {9},
      number = {3},
      pages = {104-113},
      doi = {10.11648/j.ajp.20230903.11},
      url = {https://doi.org/10.11648/j.ajp.20230903.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20230903.11},
      abstract = {Background: Coronavirus disease 2019 (COVID-19), usually causes respiratory and gastrointestinal symptoms in children. While the clinical features range from upper respiratory tract infections to severe diseases. Kidney involvement in these children has been reported in different parts of the world, with different prevalence and acuity. To date, data are still accumulating to characterize kidney involvement in this disease and its impact on these children. Objective: We aimed to determine the prevalence of renal involvement in hospitalized children with COVID-19 in the state of Qatar and describe their clinical presentation and outcome. Methods: We retrospectively reviewed all children (age 0–14 years) with COVID-19 admitted to Hamad General Hospital, from March 1, 2020, to January 1, 2021. The diagnosis was confirmed by positive PCR results for the virus. We reviewed kidney involvement in these children at presentation, during hospitalization, and at 6 weeks follow-up. Results: A total of 2586 patients who were positive by PCR were reviewed, of which 584 were excluded due to missing data, and 1602 were completely asymptomatic at presentation. A total of 400 patients were then included in this study and were divided into two groups: patients without renal involvement (non-renal group) 282 patients (70.5%), and patients with renal involvement (renal group) 118 patients (29.5%). In the renal group, the median age was 16.7 months, and 90 patients (76.3%) were female. Fever was present in 107 patients (90.7%), and the median duration of hospitalization was 3.3 days. In this group, 84 patients (71.2%) presented with respiratory symptoms, and 34 patients (28.8%) presented with gastroenterological symptoms. The most frequent manifestation of renal involvement in these patients was microscopic hematuria, followed by leukocyturia, and acute kidney injury (AKI) was present in 14 patients (12%). During the reported period and follow-up of 6 weeks, children with AKI were at an early stage, and none of them required kidney replacement therapy. Conclusion: Kidney involvement in children with COVID-19 infection in our patients was noted in almost one-third of the patients and varied from urinary findings without any clinical symptoms to early-stage AKI. Electrolyte abnormalities with metabolic acidosis can present at presentation and require careful attention and management.},
     year = {2023}
    }
    

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  • TY  - JOUR
    T1  - Renal Involvement in Hospitalized Children with COVID-19
    AU  - Mahmoud Alhandi Omar Helal
    AU  - Abubakr Imam
    AU  - Shaikha Nasser Al-Thani
    AU  - Wadha Al-Shafi
    AU  - Lujain Loay
    AU  - Farid Fatnassi
    AU  - Mahmoud Abdul Majid
    AU  - Malek Almoustafa
    AU  - Fatin A. Moussa
    AU  - Mohammed Sultan
    AU  - Moustafa Ezz
    AU  - Limia Altaj Sati Seed
    Y1  - 2023/07/08
    PY  - 2023
    N1  - https://doi.org/10.11648/j.ajp.20230903.11
    DO  - 10.11648/j.ajp.20230903.11
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
    SP  - 104
    EP  - 113
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20230903.11
    AB  - Background: Coronavirus disease 2019 (COVID-19), usually causes respiratory and gastrointestinal symptoms in children. While the clinical features range from upper respiratory tract infections to severe diseases. Kidney involvement in these children has been reported in different parts of the world, with different prevalence and acuity. To date, data are still accumulating to characterize kidney involvement in this disease and its impact on these children. Objective: We aimed to determine the prevalence of renal involvement in hospitalized children with COVID-19 in the state of Qatar and describe their clinical presentation and outcome. Methods: We retrospectively reviewed all children (age 0–14 years) with COVID-19 admitted to Hamad General Hospital, from March 1, 2020, to January 1, 2021. The diagnosis was confirmed by positive PCR results for the virus. We reviewed kidney involvement in these children at presentation, during hospitalization, and at 6 weeks follow-up. Results: A total of 2586 patients who were positive by PCR were reviewed, of which 584 were excluded due to missing data, and 1602 were completely asymptomatic at presentation. A total of 400 patients were then included in this study and were divided into two groups: patients without renal involvement (non-renal group) 282 patients (70.5%), and patients with renal involvement (renal group) 118 patients (29.5%). In the renal group, the median age was 16.7 months, and 90 patients (76.3%) were female. Fever was present in 107 patients (90.7%), and the median duration of hospitalization was 3.3 days. In this group, 84 patients (71.2%) presented with respiratory symptoms, and 34 patients (28.8%) presented with gastroenterological symptoms. The most frequent manifestation of renal involvement in these patients was microscopic hematuria, followed by leukocyturia, and acute kidney injury (AKI) was present in 14 patients (12%). During the reported period and follow-up of 6 weeks, children with AKI were at an early stage, and none of them required kidney replacement therapy. Conclusion: Kidney involvement in children with COVID-19 infection in our patients was noted in almost one-third of the patients and varied from urinary findings without any clinical symptoms to early-stage AKI. Electrolyte abnormalities with metabolic acidosis can present at presentation and require careful attention and management.
    VL  - 9
    IS  - 3
    ER  - 

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Author Information
  • Pediatric Department, Hamad General Hospital, Doha, Qatar

  • Pediatric Nephrology Department, Sidra Hospital, Doha, Qatar

  • Faculty of Medicine, Weil Cornell University, Doha, Qatar

  • Department of Dermatology, Hamad Medical Corporation, Doha, Qatar

  • Pediatric Department, Hamad General Hospital, Doha, Qatar

  • Pediatric Department, Hamad General Hospital, Doha, Qatar

  • Pediatric Department, Hamad General Hospital, Doha, Qatar

  • Pediatric Department, Hamad General Hospital, Doha, Qatar

  • Pediatric Department, Hamad General Hospital, Doha, Qatar

  • Pediatric Department, Hamad General Hospital, Doha, Qatar

  • Pediatric Department, Hamad General Hospital, Doha, Qatar

  • Pediatric Nephrology Department, Madina Maternity and Children Hospital, Al Madinah Al Munawwarah, Saudi Arabia

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