Pediatric Nephrology Department, La Paz University Hospital, Madrid, Spain.
Pediatric Nephrology Department, Sant Joan de Deu University Hospital, Barcelona, Spain.
Pediatr Nephrol. 2020 Aug;35(8):1521-1524. doi: 10.1007/s00467-020-04597-1. Epub 2020 May 20.
There is little information about Coronavirus Disease 2019 (COVID-19) in children with underlying chronic renal pathologies.
From March until April 15, 2020, 16 children with chronic renal pathologies were diagnosed with COVID-19 in Spain. Of these, 6 had end-stage kidney disease (ESKD) (3 transplant recipients and 3 on chronic hemodialysis). The severity of symptoms was mild in all the patients, with little radiological involvement. Three patients were asymptomatic. Fever and upper respiratory symptoms were the most frequent findings. Basal glomerular filtration worsened in 3 patients; however, recovery was rapidly achieved with rehydration and drug dose adjustment. In 2 patients diagnosed with steroid-dependent nephrotic syndrome, COVID-19 provoked a disease relapse. None required oxygen therapy, and 7 could be managed as outpatients.
COVID-19 disease appears to have a similar clinical course in children with underlying chronic renal pathologies, even in immunosuppressed cases, as in healthy children of the same age; however, special attention must be paid to fluid management and drug dose adjustment.
患有基础慢性肾脏疾病的儿童中,关于 2019 年冠状病毒病(COVID-19)的信息很少。
2020 年 3 月至 4 月 15 日,西班牙诊断出 16 名患有慢性肾脏疾病的儿童患有 COVID-19。其中,6 名患有终末期肾病(ESKD)(3 名移植受者和 3 名慢性血液透析患者)。所有患者的症状均较轻,影像学受累较少。有 3 名患者无症状。发烧和上呼吸道症状是最常见的发现。3 名患者的基础肾小球滤过率恶化;然而,通过补液和调整药物剂量,迅速恢复。在 2 名被诊断为类固醇依赖性肾病综合征的患者中,COVID-19 引发了疾病复发。没有患者需要氧疗,有 7 名患者可以作为门诊患者进行管理。
COVID-19 疾病在患有基础慢性肾脏疾病的儿童中,即使在免疫抑制病例中,似乎也具有与同年龄健康儿童相似的临床病程;然而,必须特别注意液体管理和药物剂量调整。