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COVID-19 and the multisystem inflammatory syndrome in children: how vulnerable are the kidneys?

Vimal Chadha1, Bradley A Warady2

  • 1Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA; Acute Kidney Injury Program, Children's Mercy Kansas City, Kansas City, Missouri, USA; Division of Nephrology, Children's Mercy Kansas City, Kansas City, Missouri, USA.

Kidney International
|June 22, 2021
PubMed

Insights

Most children with COVID-19 experience mild illness, but some develop a serious multisystem inflammatory syndrome. This study shows that while acute kidney injury can occur, most children with this condition recover kidney function.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Coronavirus disease 2019 (COVID-19) typically presents with milder symptoms in children compared to adults.
  • A subset of pediatric COVID-19 cases can lead to multisystem inflammatory syndrome (MIS-C), a serious condition.
  • MIS-C can result in severe complications, including shock and multiorgan failure.

Purpose of the Study:

  • To characterize acute kidney injury (AKI) in pediatric patients diagnosed with acute COVID-19 and MIS-C.
  • To assess the outcomes and recovery patterns of kidney function in this specific pediatric cohort.

Main Methods:

  • Retrospective analysis of pediatric patients with confirmed acute COVID-19 and MIS-C.
  • Evaluation of kidney function parameters and incidence of AKI.
  • Assessment of kidney recovery post-acute illness.

Main Results:

  • The study identified and characterized AKI in a cohort of pediatric patients with acute COVID-19 and MIS-C.
  • Despite the potential for significant morbidity associated with AKI in this context, the majority of affected children demonstrated evidence of kidney recovery.
  • This suggests a generally favorable prognosis for renal function in the long term for most pediatric patients recovering from MIS-C.

Conclusions:

  • Acute kidney injury is a notable complication in children with acute COVID-19 and multisystem inflammatory syndrome.
  • The findings provide evidence supporting kidney recovery in most pediatric cases, offering a degree of reassurance regarding long-term renal outcomes.
  • Further research may elucidate specific risk factors and management strategies for AKI in MIS-C.

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