Epidemiology, severity, and risk of SARS-CoV-2-related relapse in children and young adults affected by idiopathic nephrotic syndrome: a retrospective observational cohort study,Pediatric Nephrology

当前位置： X-MOL 学术 › Pediatr. Nephrol. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Epidemiology, severity, and risk of SARS-CoV-2-related relapse in children and young adults affected by idiopathic nephrotic syndrome: a retrospective observational cohort study
Pediatric Nephrology ( IF 3 ) Pub Date : 2022-09-22 , DOI: 10.1007/s00467-022-05736-6
William Morello ₁ , Federica Alessandra Vianello ₁ , Chiara Bulgaro ₁ , Giovanni Montini _{1,

2}

Affiliation

Background

Children with underlying kidney diseases display a mild course of SARS-CoV-2 infection, but they only accounted for a minority of cases until the spread of the Omicron variant. Nonetheless, idiopathic nephrotic syndrome (INS) has been advocated as a predictor of worse outcome.

Methods

We investigated the spread, severity, and risk of relapse related to SARS-CoV-2 infection among children with INS. The incidence and characteristics of SARS-CoV-2 infections, immunosuppression, and vaccination status were retrospectively collected from the beginning of the pandemic to May 31, 2022.

Results

We enrolled 176 patients (73 females, median age 10.22 years); 28 had a steroid-resistant disease, and 108 (61.4%) were on immunosuppressive therapy. Sixty-one (34.7%) patients reported a SARS-CoV-2 infection, with incidence peaking between December 2021 and January 2022. No hospitalization or deaths were reported, and symptoms were absent or mild. The rate of SARS-CoV-2 infection was similar in children with and without immunosuppression (33.8% vs 35.2%; p = 0.85). None of the 38 immunosuppressed patients discontinued the therapy, but they had a longer time to negativization (13.31 vs. 10.04 days; p = 0.03). Proteinuria was detected in 7 patients, but only one had a relapse requiring steroid therapy, with prompt remission and a mild course.

Conclusions

After the spread of the Omicron variant, the rate of SARS-CoV-2 infection in children with INS was much higher than previously reported. In this large cohort, symptoms were mild, even in immunosuppressed patients and those with proteinuria. During the infection, transient proteinuria was common with a low rate of relapses.

Graphical abstract

中文翻译：

受特发性肾病综合征影响的儿童和年轻人 SARS-CoV-2 相关复发的流行病学、严重程度和风险：一项回顾性观察队列研究

背景

患有潜在肾脏疾病的儿童表现出轻微的 SARS-CoV-2 感染过程，但在 Omicron 变体传播之前，他们只占少数病例。尽管如此，特发性肾病综合征 (INS) 已被提倡作为较差结果的预测因子。

方法

我们调查了 INS 儿童中与 SARS-CoV-2 感染相关的传播、严重性和复发风险。回顾性收集了从大流行开始到 2022 年 5 月 31 日期间 SARS-CoV-2 感染的发病率和特征、免疫抑制和疫苗接种状况。

结果

我们招募了 176 名患者（73 名女性，中位年龄 10.22 岁）；28 人患有类固醇耐药性疾病，108 人 (61.4%) 正在接受免疫抑制治疗。61 名 (34.7%) 患者报告了 SARS-CoV-2 感染，发病率在 2021 年 12 月至 2022 年 1 月之间达到高峰。没有住院或死亡的报告，没有症状或症状轻微。有和没有免疫抑制的儿童的 SARS-CoV-2 感染率相似（33.8% 对 35.2%；p = 0.85）。38 名免疫抑制患者均未停止治疗，但他们的阴性化时间更长（13.31 对 10.04 天；p = 0.03）。7 名患者检测到蛋白尿，但只有 1 名患者复发需要类固醇治疗，病情迅速缓解且病程较轻。