COVID-19 in pediatric kidney transplantation: The Improving Renal Outcomes Collaborative

Am J Transplant. 2021 Aug;21(8):2740-2748. doi: 10.1111/ajt.16501. Epub 2021 Feb 11.

Abstract

There are limited data on the impact of COVID-19 in children with a kidney transplant (KT). We conducted a prospective cohort study through the Improving Renal Outcomes Collaborative (IROC) to collect clinical outcome data about COVID-19 in pediatric KT patients. Twenty-two IROC centers that care for 2732 patients submitted testing and outcomes data for 281 patients tested for SARS-CoV-2 by PCR. Testing indications included symptoms and/or potential exposures to COVID-19 (N = 134, 47.7%) and/or testing per hospital policy (N = 154, 54.8%). Overall, 24 (8.5%) patients tested positive, of which 15 (63%) were symptomatic. Of the COVID-19-positive patients, 16 were managed as outpatients, six received non-ICU inpatient care and two were admitted to the ICU. There were no episodes of respiratory failure, allograft loss, or death associated with COVID-19. To estimate incidence, subanalysis was performed for 13 centers that care for 1686 patients that submitted all negative and positive COVID-19 results. Of the 229 tested patients at these 13 centers, 10 (5 asymptomatic) patients tested positive, yielding an overall incidence of 0.6% and an incidence among tested patients of 4.4%. Pediatric KT patients in the United States had a low estimated incidence of COVID-19 disease and excellent short-term outcomes.

Keywords: clinical research/practice; epidemiology; health services and outcomes research; infection and infectious agents; infectious disease; kidney transplantation/nephrology; pediatrics.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • COVID-19*
  • Child
  • Humans
  • Incidence
  • Kidney Transplantation* / adverse effects
  • Prospective Studies
  • SARS-CoV-2