Department of Pediatrics, Division of Pediatric Nephrology, University of California at San Diego and Rady Children's Hospital, 3020 Children's Way MC 5173, San Diego, CA, 92123, USA.
Department of Pediatrics, Division of Pediatric Nephrology, Yale University School of Medicine, New Haven, CT, USA.
Pediatr Nephrol. 2022 Nov;37(11):2679-2685. doi: 10.1007/s00467-022-05483-8. Epub 2022 Feb 24.
Infections are thought to be primarily responsible for triggering relapse in children with steroid-sensitive nephrotic syndrome (NS). The COVID-19 pandemic promoted physical distancing, facial mask wearing, and greater attention to infection-prevention measures resulting in decreased transmission of infections. We hypothesized there would also be a decreased rate of NS relapse during this period.
We conducted a single-center retrospective chart review of children with steroid-sensitive NS. Demographics, rate of relapses, and rate of hospitalizations were collected for a baseline pre-pandemic period (BPP) and for the social distancing period during the pandemic (SDP).
One hundred twenty-two children with primary steroid-sensitive NS were identified and 109 were followed for the duration of the study period. The paired rate of relapse per subject per year was significantly lower during the SDP (0.6 relapses per subject per year ± 1 SD) compared to the BPP (1.0 relapses per subject per year ± 0.9 SD), P < 0.01. A subgroup of 32 subjects who were newly diagnosed with NS during the BPP similarly had significantly fewer relapses during the SDP (0.8 ± 1 SD) than during the BPP (1.4 ± 1 SD), P = 0.01.
Our results support the hypothesis of lower rates of NS relapse and hospitalizations during social distancing for all subjects in our cohort and a subgroup of those newly diagnosed. Lower relapse rates were likely attributable to decreased transmission of infections and greater attention to infection prevention. A higher resolution version of the Graphical abstract is available as Supplementary information.
人们认为感染主要负责引发儿童类固醇敏感性肾病综合征（NS）的复发。COVID-19 大流行促使人们保持身体距离、佩戴口罩，并更加关注感染预防措施，从而降低了感染的传播。我们假设在此期间 NS 的复发率也会降低。
我们对患有类固醇敏感性 NS 的儿童进行了单中心回顾性图表审查。收集了人口统计学数据、复发率和住院率，用于基线大流行前时期（BPP）和大流行期间社交距离时期（SDP）。
确定了 122 名原发性类固醇敏感性 NS 儿童，其中 109 名在研究期间得到了随访。与 BPP（1.0 次复发/受试者/年±0.9 SD）相比，SDP（0.6 次复发/受试者/年±1 SD）时每个受试者每年的复发率显著降低，P < 0.01。在 BPP 期间新诊断为 NS 的 32 名受试者的亚组中，SDP 期间（0.8±1 SD）的复发次数明显少于 BPP 期间（1.4±1 SD），P=0.01。
我们的结果支持这样的假设，即在我们的队列中所有受试者和新诊断的亚组中，社会隔离期间 NS 复发和住院的比率较低。较低的复发率可能归因于感染传播的减少和对感染预防的更多关注。更高分辨率的图表摘要可在补充资料中获得。
