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Acute kidney injury in critically ill children with COVID-19 and MIS-C

Hasan Özen1, Ayşen Durak Aslan2, Burak Balaban3

  • 1Department of Pediatric Intensive Care, Faculty of Medicine, Ankara University School of Medicine, Ankara, Turkey. ozen87@hotmail.com.

Pediatric Nephrology (Berlin, Germany)
|May 12, 2023
PubMed

Insights

Acute kidney injury (AKI) affects many children with COVID-19 and multisystem inflammatory syndrome (MIS-C). Identifying risk factors like low calcium and hypotension is crucial for better outcomes in pediatric intensive care units (PICUs).

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and multisystem inflammatory syndrome (MIS-C) can lead to serious complications in children.
  • Acute kidney injury (AKI) is a significant concern in critically ill pediatric patients.
  • Understanding AKI incidence in these specific pediatric populations is vital for clinical management.

Purpose of the Study:

  • To determine the incidence of AKI in children diagnosed with SARS-CoV-2 (COVID-19) and MIS-C.
  • To analyze clinical risk factors associated with AKI development in these pediatric cohorts.
  • To report clinical experiences and outcomes related to AKI in pediatric intensive care units (PICUs).

Main Methods:

  • Retrospective analysis of pediatric patients diagnosed with acute COVID-19 or MIS-C between 2019 and 2021.
  • Comparison of AKI incidence between COVID-19 and MIS-C patient groups.
  • Statistical analysis to identify risk factors for AKI, including demographic, clinical, and treatment-related variables.

Main Results:

  • AKI was observed in 40.8% of acute COVID-19 patients and 27.7% of MIS-C patients.
  • Low calcium levels, hypotension, and nephrotoxic medication use were significant risk factors for AKI.
  • Respiratory distress and cough were associated with a higher likelihood of AKI.
  • AKI patients required more respiratory support and had longer PICU stays.

Conclusions:

  • AKI in pediatric COVID-19 and MIS-C patients is linked to increased mortality and prolonged hospitalization.
  • Early identification and prevention of AKI risk factors are essential for improving patient outcomes.
  • Clinical vigilance for AKI is necessary in children presenting with respiratory symptoms during these pandemics.
Abstract

Keywords:
Acute kidney injuryMultisystem inflammatory syndromePediatric intensive careSARS-CoV-2

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