Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 7022, Cincinnati, OH, 45229, USA.
University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Pediatr Nephrol. 2023 Feb;38(2):537-547. doi: 10.1007/s00467-022-05570-w. Epub 2022 May 11.
We report follow-up data from an ongoing prospective cohort study of COVID-19 in pediatric kidney transplantation through the Improving Renal Outcomes Collaborative (IROC).
Patient-level data from the IROC registry were combined with testing, indication, and outcomes data collected to describe the epidemiology of COVID testing, treatment, and clinical outcomes; determine the incidence of a positive COVID-19 test; describe rates of COVID-19 testing; and assess for clinical predictors of a positive COVID-19 test.
From September 2020 to February 2021, 21 centers that care for 2690 patients submitted data from 648 COVID-19 tests on 465 patients. Most patients required supportive care only and were treated as outpatients, 16% experienced inpatient care, and 5% experienced intensive care. Allograft complications were rare, with acute kidney injury most common (7%). There was 1 case of respiratory failure and 1 death attributed to COVID-19. Twelve centers that care for 1730 patients submitted complete testing data on 351 patients. The incidence of COVID-19 among patients at these centers was 4%, whereas the incidence among tested patients was 19%. Risk factors to predict a positive COVID-19 test included age > 12 years, symptoms consistent with COVID-19, and close contact with a confirmed case of COVID-19.
Despite the increase in testing and positive tests over this study period, the incidence of allograft loss or death related to COVID-19 remained extremely low, with allograft loss or death each occurring in < 1% of COVID-19-positive patients and in less than < 0.1% of all transplant patients within the IROC cohort. A higher resolution version of the Graphical abstract is available as Supplementary information.
我们报告了一项正在进行的 COVID-19 儿科肾移植前瞻性队列研究的随访数据，该研究通过改善肾移植结局协作组织（IROC）进行。
将 IROC 注册中心的患者水平数据与收集的检测、指征和结局数据相结合，以描述 COVID 检测、治疗和临床结局的流行病学；确定 COVID-19 检测阳性的发生率；描述 COVID-19 检测率；并评估 COVID-19 检测阳性的临床预测因素。
从 2020 年 9 月至 2021 年 2 月，21 家护理 2690 名患者的中心向 465 名患者的 648 次 COVID-19 检测提交了数据。大多数患者仅需要支持性护理并接受门诊治疗，16%的患者需要住院治疗，5%的患者需要重症监护。同种异体移植物并发症罕见，以急性肾损伤最常见（7%）。有 1 例呼吸衰竭和 1 例 COVID-19 死亡病例。12 家护理 1730 名患者的中心向 351 名患者提交了完整的检测数据。这些中心的患者 COVID-19 发病率为 4%，而接受检测患者的发病率为 19%。预测 COVID-19 检测阳性的危险因素包括年龄>12 岁、有 COVID-19 症状且与确诊 COVID-19 病例密切接触。
尽管在此研究期间检测和阳性检测数量有所增加，但与 COVID-19 相关的移植物丢失或死亡的发生率仍然极低，在 COVID-19 阳性患者中，每种情况的发生率均<1%，在 IROC 队列的所有移植患者中，<0.1%。可提供图形摘要的更高分辨率版本作为补充信息。
