COVID-19 in transplant recipient children: An Iranian referral hospital-based study
Golnaz Ghazizadeh Esslami1, Setareh Mamishi2, Shima Mahmoudi3
1Tehran University of Medical Sciences. gh.esslami@gmail.com.
Insights
Pediatric transplant patients with COVID-19 experienced severe illness and high mortality. This study highlights critical clinical, laboratory, and radiologic findings in this vulnerable population.
Area of Science:
- Pediatric critical care
- Infectious diseases
- Transplant medicine
Background:
- Limited data exists on COVID-19 in pediatric transplant recipients.
- Understanding disease characteristics in immunocompromised children is crucial.
Purpose of the Study:
- To analyze the clinical, laboratory, and radiologic findings of COVID-19 in pediatric transplant patients.
- To assess the severity and mortality rates in this cohort.
Main Methods:
- Retrospective analysis of 7 pediatric transplant recipients with confirmed COVID-19.
- Review of clinical presentation, laboratory results (CBC), and CT imaging findings.
- Assessment of disease severity and outcomes.
Main Results:
- All patients presented with fever; cough and dyspnea were common.
- Lymphocytopenia and thrombocytopenia were frequent laboratory findings.
- CT scans revealed ground glass opacities, consolidations, and bilateral lung involvement.
- 51% experienced severe disease, with a 28.6% mortality rate.
Conclusions:
- Pediatric transplant recipients with COVID-19 face significant risks of severe disease and mortality.
- Findings underscore the vulnerability of immunocompromised pediatric populations to severe COVID-19 outcomes.
Abstract:
To our knowledge, there is still very limited information on the severity, mortality, laboratory, and radiologic findings of COVID-19 infection in transplant patients, particularly children. In this study, we report and analyze 7 transplant recipients with laboratory-confirmed COVID-19 infection. The median age was 7.5 years (IQR: 31month-10 years), and 71% of the patients were male. All cases presented with a fever. The median duration of fever before admission was 2 days (IQR:1-8 days). Five patients (71%) experienced cough and dyspnea. Lymphocytopenia (Median of 0.6 (IQR: 0.14-2.0× 10⁹ cells per L) and thrombocytopenia (Median of 65 (IQR: 49-201× 10⁹ cells per L) were the most common CBC findings (both seen in 5 out of the 7 patients. Among 4 of the patients who underwent CT scans, 2 had ground glass opacity and consolidations. The mean number of lobe involvement in our patients was 3(0-5), and 75% of the cases showed bilateral lung involvement in the imaging. In 4 patients (51%) the disease course manifested severely, and 2 patients are now deceased (28.6%). In conclusion, immunocompromised pediatric subgroups may experience higher rates of disease severity and mortality in comparison with the immunocompetent pediatric population.
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