Article Text

Download PDFPDF
National study on the risks of COVID-19 infection for paediatric kidney transplant recipients: a retrospective, cross-sectional study
  1. Charlotte Withers1,2,
  2. Rishil Patel1,2,
  3. Ben C Reynolds3,
  4. Martin Christian4,
  5. Mordi Muorah5,
  6. Yincent Tse6,
  7. Liz Edwards7,
  8. Pallavi Yadav8,
  9. Shuman Haq9,
  10. Shivaram Hegde10,
  11. Chris J Callaghan2,
  12. Alasdair Bamford11,
  13. Stephen D Marks1,2
  1. 1 NIHR Great Ormond Street Hospital Biomedical Research Centre, University College London Great Ormond Street Institute of Child Health, London, UK
  2. 2 Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  3. 3 Paediatric Renal Unit, Royal Hospital for Children, Glasgow, UK
  4. 4 Nottingham Children's Hospital, Nottingham, UK
  5. 5 Department of Paediatric Nephrology, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
  6. 6 Department of Paediatric Nephrology, Great North Children's Hospital, Newcastle Upon Tyne, UK
  7. 7 Royal Manchester Children's Hospital, Manchester, Manchester, UK
  8. 8 Department of Paediatric Nephrology, Leeds Teaching Hospitals NHS Trust, Leeds, Leeds, UK
  9. 9 Department of Paediatric Nephrology, Southampton Children’s Hospital, Southampton, UK
  10. 10 Noah's Ark Children's Hospital for Wales, Cardiff, UK
  11. 11 Deparment of Paediatric Infectious Diseases, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  1. Correspondence to Professor Stephen D Marks, Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK; stephen.marks{at}gosh.nhs.uk

Abstract

Introduction During the COVID-19 pandemic, evidence emerged that immunosuppressed children were less affected by COVID-19 infections compared with immunosuppressed adults. The aim of our study was to investigate how COVID-19 infections affected paediatric kidney transplant recipients (pKTR) in the UK.

Methods Questionnaires regarding COVID-19 infection data and care of pKTR during the COVID-19 pandemic were sent to all 13 UK paediatric nephrology centres examining asymptomatic and symptomatic pKTR with positive COVID-19 PCR testing from 1 April 2020 to 1 December 2021.

Results 63 pKTR who were 3.1 (range 0.1–15) years post-transplantation had COVID-19 infection with positive SARS-CoV-2 PCR RNA. Classical COVID-19 symptoms were present in half of the patients; with atypical presentations including diarrhoea (13%) and lethargy (13%) also noted, while a third of patients were asymptomatic. Eighteen patients (28%) were hospitalised including five asymptomatic patients admitted for other reasons. No patients needed ventilation or intensive care admission, and one patient received supplemental oxygen. There was evidence of acute kidney injury (AKI) in 71% of patients, but no patients needed kidney replacement therapy with haemofiltration or dialysis.

Conclusion We report 10.4% of the UK paediatric renal transplantation population had documented COVID-19 infections with positive SARS-CoV-2 PCR RNA with 28% of those affected requiring hospitalisation. The increased incidence of AKI, particularly after the first wave of the COVID-19 pandemic, was possibly due to increased testing. There was low morbidity and mortality compared with the adult population.

  • COVID-19
  • Nephrology
  • Paediatrics

Data availability statement

Data are available upon reasonable request. Results of questionnaire are available on request.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

Data are available upon reasonable request. Results of questionnaire are available on request.

View Full Text

Footnotes

  • CW and RP are joint first authors.

  • Twitter @YincentTse, @kidskidneymarks

  • Contributors CW and RP provided substantial contributions to the conception and design of the work, the interpretation of data, drafting of the work and final approval of the version to be published. Both are in agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. SDM (corresponding author) provided a substantial contribution to the conception and design of the work, the interpretation of data, critical review of the work and final approval of the version to be published. SDM is the guarantor and as such is in agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. BCR, MC, MM, YT, LE, PY, ShuH, ShiH, CJC and AB provided substantial contributions to the acquisition and interpretation of data for the work, critical review of the work and final approval of the version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests SDM had unpaid roles during COVID-19 pandemic with national COVID-19 working groups of the UK Kidney Association, UK Renal Registry, The British Association for Paediatric Nephrology, National Health Service Blood and Transplant and National Institute for Health and Care Research.

  • Provenance and peer review Not commissioned; externally peer-reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.