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急性肾损伤:儿童和青少年的新冠病毒感染后并发症。

Acute kidney injury: a post-COVID-19 complication in children and adolescents.

机构信息

Universidade Positivo, Curitiba, PA, Brazil.

出版信息

Rev Paul Pediatr. 2024 Sep 6;43:e2023171. doi: 10.1590/1984-0462/2025/43/2023171. eCollection 2024.

Abstract

OBJECTIVE

To describe cases of acute kidney injury (AKI) in children diagnosed with COVID-19, associated risk factors, clinical aspects and outcome of cases.

METHODS

Retrospective study, carried out in a pediatric hospital between March 2020 and September 2021, with patients with COVID-19 who were diagnosed with AKI, studying information present in medical records such as comorbidities, age, gender and use of nephrotoxic medications.

RESULTS

We studied 40 cases, and male individuals were significantly more affected (62.5%; p=0.025). AKI was a severe complication of COVID-19 infection, with 100% of the sample requiring admission to the Intensive Care Unit and 22.5% dying. The most prevalent comorbidities analyzed in this study were epilepsy, cerebral palsy and heart disease. Most patients were classified according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria as KDIGO 1 (42.5%), and required orotracheal intubation (67.5%). The frequency of use of nephrotoxic medications and need for dialysis was low, with percentages of 35 and 17.5%, respectively. Among the children who died, 70.4% had some comorbidity and 88.8% received invasive ventilation.

CONCLUSIONS

AKI in children with COVID-19 infection is associated with severe conditions. Despite the severity, most patients were discharged alive from the hospital.

摘要

目的

描述 COVID-19 患儿中急性肾损伤(AKI)的病例,相关危险因素、临床方面和病例结局。

方法

这是一项回顾性研究,于 2020 年 3 月至 2021 年 9 月在一家儿科医院进行,研究对象为诊断为 AKI 的 COVID-19 患儿,研究内容包括病历中存在的合并症、年龄、性别和肾毒性药物使用等信息。

结果

共研究了 40 例病例,男性受影响更为显著(62.5%;p=0.025)。AKI 是 COVID-19 感染的严重并发症,样本中 100%需要入住重症监护病房,22.5%死亡。本研究中分析的最常见合并症是癫痫、脑瘫和心脏病。大多数患者根据肾脏病:改善全球结局(KDIGO)标准分类为 KDIGO 1(42.5%),需要经口气管插管(67.5%)。肾毒性药物的使用频率和透析的需求较低,分别为 35%和 17.5%。死亡的儿童中,70.4%有某种合并症,88.8%接受了有创通气。

结论

COVID-19 感染患儿的 AKI 与严重情况相关。尽管病情严重,但大多数患者从医院出院时仍存活。

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