Doctors from Turkey warns that children exposed to SARS-CoV-2 are at risk of acute kidney injury
Nikhil Prasad Fact checked by:Thailand Medical News Team Jul 22, 2024 4 months, 8 hours, 10 minutes ago
COVID-19 News: A Troubling Discovery
The COVID-19 pandemic has impacted people of all ages, but a recent study has revealed a concerning trend among children infected with the virus. Researchers from Dr Sami Ulus Women’s and Children’s Health Training and Research Hospital in Ankara, Turkey, have discovered that acute kidney injury (AKI) is a significant risk for pediatric COVID-19 patients. This
COVID-19 News report explores the key findings of their study and the implications for children's health.
Doctors from Turkey warns that children exposed to SARS-CoV-2 are at risk of acute kidney injury
Image Credit: amriphoto / iStock
Understanding Acute Kidney Injury (AKI)
Acute kidney injury, or AKI, is a sudden episode of kidney failure or damage that happens within a few hours or days. It causes waste products to build up in the blood and makes it hard for kidneys to maintain the right balance of fluid in the body. AKI can also affect other organs such as the brain, heart, and lungs. In the context of COVID-19, AKI has been recognized as a serious complication, particularly in hospitalized adults. However, its impact on children has been less clear - until now.
Thailand Medical News has been warning since early 2020 that many exposed to SARS-CoV-2, despite being asymptomatic or mildly symptomatic will develop kidney injury and also chronic kidney disease and kidney failure over a course of time.
https://www.thailandmedical.news/news/study-shows-that-kidney-function-and-egfr-decreases-at-six-months-after-sars-cov-2-infection-for-long-covid-patients
https://www.thailandmedical.news/news/german-study-warns-that-sars-cov-2-infections-are-causing-acute-kidney-injury-and-kidney-damage
https://www.thailandmedical.news/news/more-than-one-third-of-children-who-had-post-covid-19-multisystem-inflammatory-syndrome-developed-acute-kidney-injury
https://www.thailandmedical.news/news/covid-19-induced-kidney-damage-caused-by-sars-cov-2-using-receptors-such-as-tlr-4-kim-1-tim-1-and-cd147
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https://www.thailandmedical.news/news/covid-19-associated-nephropathy-an-emerging-health-threat
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https://www.thailandmedical.news/news/breaking-covid-19-news-sars-cov-2-orf3a-protein-damages-renal-tubules-via-trim59-induced-stat3-activation-causing-acute-kidney-injury
https://www.thailandmedical.news/news/university-of-queensland-study-warns-that-millions-of-sars-cov-2-infected-individuals-are-not-aware-that-they-may-have-undiagnosed-acute-kidney-injury
https://www.thailandmedical.news/news/dutch-and-german-study-shows-that-sars-cov-2-directly-infects-the-kidneys-and-causes-tissue-scarring-which-ultimately-leads-to-kidney-damage-and-failu
https://www.thailandmedical.news/news/university-of-washington-study-confirms-that-sars-cov-2-can-directly-invade-human-kidney-cells-causing-a-range-of-kidney-issues-including-acute-kidney
https://www.thailandmedical.news/news/more-great-news-even-those-that-initially-had-mild-covid-19-symptoms-can-develop-kidney-disease-as-part-of-many-manifestations-of-long-covid
https://www.thailandmedical.news/news/good-news-study-finds-that-most-recovered-covid-19-patients-even-with-mild-infections-will-ultimately-develop-virus-induced-kidney-damage
https://www.thailandmedical.news/news/study-finds-that-covid-19-induced-acute-kidney-injury-similar-to-sepsis-caused-kidney-injury-and-that-mitochondrial-dysfunction-may-play-a-key-role
https://www.thailandmedical.news/news/warning-covid-19-latest-researchers-warn-of-epidemic-of-post-covid-19-kidney-disease-and-study-shows-many-will-die-or-never-recover-from-aki
https://www.thailandmedical.news/news/acute-kidney-injury-study-shows-that-acute-kidney-injury-(aki)-predominant-among-covid-19-patients
https://www.thailandmedical.news/news/covid-19-clinical-care-kidney-failure-emerging-as-a-common-occurrence-from-covid-19-infections
The Study: A Comprehensive Analysis
The research team, including Dr Fatma Yazılıtaş, Dr Evrim Kargın Çakıcı, Dr Tülin Güngör, Dr Deniz Karakaya, Dr Evra Çelikkaya, Dr Zeynep Savaş Şen, Dr Rüveyda Gümüşer, Dr Naciye Gönül Tanır, and Dr Mehmet Bülbül, conducted a retrospective observational study. They reviewed medical records of children aged one month to 18 years who were diagnosed with COVID-19 and treated at their hospital between March 2020 and March 2022.
A total of 6,683 pediatric patients with COVID-19 were evaluated, out of which 486 were included in the study based on the availability of their serum creatinine levels. The presence of AKI was identified in these children using established medical criteria.
Key Findings: AKI Prevalence and Risk Factors
The study found that AKI occurred in 3.7% of outpatient children and 23.9% of hospitalized children with COVID-19. This finding highlights that not only hospitalized children but also those treated as outpatients are at risk.
Several risk factors for AKI in children with COVID-19 were identified:
-History of Contact: Children who had been in contact with a COVID-19 positive person were at a significantly higher risk of developing AKI.
-Age: Younger children, particularly those under 12 months, were more susceptible.
-Comorbidities: Children with existing health conditions, such as cardiovascular diseases, endocrine disorders, and hematological conditions, were more likely to develop AKI.
-Symptoms and Lab Findings: Symptoms like abdominal pain, anorexia, and dyspnea (difficulty breathing) were associated with higher AKI risk. Laboratory findings showed that elevated levels of lactate dehydrogenase (LDH), higher neutrophil counts, higher neutrophil-to-lymphocyte ratios (NLR), elevated white blood cell counts, and increased C-reactive protein (CRP) levels were significant predictors.
Clinical Outcomes: Hospitalization and Mortality
Children with COVID-19 and AKI had worse clinical outcomes compared to those without AKI. They had higher rates of hospitalization, longer hospital stays, increased need for pediatric intensive care unit (PICU) admission, and a greater requirement for mechanical ventilation. The mortality rate among children with AKI was also notably higher.
Implications: The Need for Vigilant Monitoring
These findings underscore the importance of monitoring kidney function in pediatric COVID-19 patients. Given the significant association between AKI and severe outcomes, early identification and management of AKI could potentially improve prognosis and reduce the risk of long-term kidney damage.
Conclusion: Moving Forward with Awareness and Preparedness
This study sheds light on a critical but often overlooked aspect of pediatric COVID-19 care. As we continue to navigate the challenges of the pandemic, healthcare providers must remain vigilant in monitoring for signs of AKI in children with COVID-19. Early intervention and supportive care are crucial to mitigate the risks associated with this serious complication.
The study's findings were published in the peer-reviewed Journal of Nephrology.
https://link.springer.com/article/10.1007/s40620-024-01986-9
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