RT Journal Article
SR Electronic
T1 COVID-19 in children treated with immunosuppressive medication for kidney diseases
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP archdischild-2020-320616
DO 10.1136/archdischild-2020-320616
A1 Matko Marlais
A1 Tanja Wlodkowski
A1 Samhar Al-Akash
A1 Petr Ananin
A1 Varun Kumar Bandi
A1 Veronique Baudouin
A1 Olivia Boyer
A1 Luciola Vásquez
A1 Sukanya Govindan
A1 Nakysa Hooman
A1 Iftikhar Ijaz
A1 Reyner Loza
A1 Marta Melgosa
A1 Nivedita Pande
A1 Lars Pape
A1 Anshuman Saha
A1 Dmitry Samsonov
A1 Michiel F Schreuder
A1 Jyoti Sharma
A1 Sahar Siddiqui
A1 Rajiv Sinha
A1 Heather Stewart
A1 Velibor Tasic
A1 Burkhard Tönshoff
A1 Katherine Twombley
A1 Kiran Upadhyay
A1 Marina Vivarelli
A1 Donald J Weaver
A1 Robert Woroniecki
A1 Franz Schaefer
A1 Kjell Tullus
YR 2020
UL http://adc.bmj.com/content/early/2020/12/20/archdischild-2020-320616.abstract
AB Background Children are recognised as at lower risk of severe COVID-19 compared with adults, but the impact of immunosuppression is yet to be determined. This study aims to describe the clinical course of COVID-19 in children with kidney disease taking immunosuppressive medication and to assess disease severity.Methods Cross-sectional study hosted by the European Rare Kidney Disease Reference Network and supported by the European, Asian and International paediatric nephrology societies. Anonymised data were submitted online for any child (age <20 years) with COVID-19 taking immunosuppressive medication for a kidney condition. Study recruited for 16 weeks from 15 March 2020 to 05 July 2020. The primary outcome was severity of COVID-19.Results 113 children were reported in this study from 30 different countries. Median age: 13 years (49% male). Main underlying reasons for immunosuppressive therapy: kidney transplant (47%), nephrotic syndrome (27%), systemic lupus erythematosus (10%). Immunosuppressive medications used include: glucocorticoids (76%), mycophenolate mofetil (MMF) (54%), tacrolimus/ciclosporine A (58%), rituximab/ofatumumab (11%). 78% required no respiratory support during COVID-19 illness, 5% required bi-level positive airway pressure or ventilation. Four children died; all deaths reported were from low-income countries with associated comorbidities. There was no significant difference in severity of COVID-19 based on gender, dialysis status, underlying kidney condition, and type or number of immunosuppressive medications.Conclusions This global study shows most children with a kidney disease taking immunosuppressive medication have mild disease with SARS-CoV-2 infection. We therefore suggest that children on immunosuppressive therapy should not be more strictly isolated than children who are not on immunosuppressive therapy.