Department of Nephrology, Akron Children's Hospital, Akron, OH, United States of America.
Department of Nephrology, Akron Nephrology Associates/ Cleveland Clinic Akron General Medical Center, Akron, OH, United States of America.
PLoS One. 2022 Apr 26;17(4):e0266737. doi: 10.1371/journal.pone.0266737. eCollection 2022.
Despite extensive research into acute kidney injury (AKI) in adults, research into the epidemiology, associated risk factors, treatment, and mortality of AKI in pediatric COVID-19 patients is understudied. Advancing understanding of this disease is crucial to further developing treatment and preventative care strategies to reduce morbidity and mortality.
This is a retrospective analysis of 2,546 COVID-19 pediatric patients (age ≤ 21 years) who were admitted the ICU in North America. Analysis of the Virtual Pediatric Systems (VPS) COVID-19 database was conducted between January 1, 2020, and June 30, 2021.
Out of a total of 2,546 COVID positive pediatric patients, 10.8% (n = 274) were diagnosed with AKI. Significantly higher continuous and categorical outcomes in the AKI subset compared to the non-AKI cohort included: length of stay at the hospital (LOS) [9.04 (5.11-16.66) vs. 5.09 (2.58-9.94) days], Pediatric Index of Mortality (PIM) 2 probability of death [1.20 (0.86-3.83) vs. 0.96 (0.79-1.72)], PIM 3 probability of death [0.98 (0.72-2.93) vs. 0.78 (0.69-1.26)], mortality [crude OR (95% CI): 5.01 (2.89-8.70)], airway and respiratory support [1.63 (1.27-2.10)], cardio-respiratory support [3.57 (1.55-8.23)], kidney support [12.52 (5.30-29.58)], and vascular access [4.84 (3.70-6.32)].
This is one of the first large scale studies to analyze AKI among pediatric COVID-19 patients admitted to the ICU in North America. Although the course of the COVID-19 virus appears milder in the pediatric population, renal complications may result, increasing the risk of disease complication and mortality.
尽管成人急性肾损伤（AKI）的研究广泛，但儿科 COVID-19 患者 AKI 的流行病学、相关危险因素、治疗和死亡率的研究仍不足。深入了解这种疾病对于进一步制定治疗和预防护理策略以降低发病率和死亡率至关重要。
这是一项对北美 ICU 收治的 2546 例 COVID-19 儿科患者（年龄≤21 岁）的回顾性分析。对 2020 年 1 月 1 日至 2021 年 6 月 30 日期间虚拟儿科系统（VPS）COVID-19 数据库进行了分析。
在总共 2546 例 COVID 阳性儿科患者中，10.8%（n=274）被诊断为 AKI。与非 AKI 队列相比，AKI 亚组的连续和分类结果显著更高，包括：医院住院时间（LOS）[9.04（5.11-16.66）vs. 5.09（2.58-9.94）天]、儿科死亡率指数（PIM）2 死亡概率[1.20（0.86-3.83）vs. 0.96（0.79-1.72）]、PIM 3 死亡概率[0.98（0.72-2.93）vs. 0.78（0.69-1.26）]、死亡率[粗比值比（95%CI）：5.01（2.89-8.70）]、气道和呼吸支持[1.63（1.27-2.10）]、心肺支持[3.57（1.55-8.23）]、肾脏支持[12.52（5.30-29.58）]和血管通路[4.84（3.70-6.32）]。
这是北美 ICU 收治的儿科 COVID-19 患者 AKI 的首批大规模研究之一。尽管 COVID-19 病毒在儿科人群中的病程似乎较轻，但可能会出现肾脏并发症，增加疾病并发症和死亡率的风险。
