Post-infectious glomerulonephritis among children before and during the COVID-19 pandemic

Post-infectious glomerulonephritis (PIGN) is a common cause of glomerulonephritis in children worldwide. The coronavirus disease 2019 (COVID-19) pandemic impacted the epidemiology of several infectious diseases; however, little is known about its effect on the epidemiology of PIGN. This study compared the epidemiology, clinical presentations, and outcomes of childhood PIGN before and during the COVID-19 pandemic.

This multicenter case control study involved six Saudi Arabian centers. Children aged 0-18 years diagnosed with PIGN from 2016 to 2023 were included. The clinical, laboratory, and outcome data of children diagnosed before and during the COVID-19 pandemic (2016-2019 and 2020-2023) were compared.

A total of 141 patients were enrolled. Patients who presented during the pandemic were younger, and the clinical presentation of PIGN was milder, particularly regarding the rate of oliguria, and the severity of proteinuria in patients with acute post-streptococcal glomerulonephritis. A lower median C3 level was found in the pre-COVID-19 pandemic cohort. More patients with high anti-streptolysin O antibody levels were noted before the pandemic, while more cases had positive GAS throat cultures during the pandemic.

PIGN incidence decreased during the early COVID-19 pandemic (2020-2022), followed by a resurgence of cases with an altered seasonality pattern. During the pandemic, children with PIGN were younger and had milder disease severity.