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