Renal Involvement in Hospitalized Children With COVID-19

  • STATUS
    Recruiting
  • End date
    Dec 31, 2021
  • participants needed
    500
  • sponsor
    Hamad Medical Corporation
Updated on 25 March 2021

Summary

Covid-19 is an important human and animal pathogen, it mostly causes respiratory and gastrointestinal symptoms. Clinical features range from a common cold to severe diseases such as severe acute respiratory distress syndrome, bronchitis, pneumonia, multi-organ failure, and even death. It seems to be less commonly affecting children and to cause fewer symptoms and less severe disease in this age group compared with adults. Clinicians have observed many extrapulmonary manifestations of COVID-19, as hematologic, cardiovascular, renal, gastrointestinal and hepatobiliary, endocrinologic, neurologic, ophthalmologic, and dermatologic systems can all be affected. This retrospective study that will be conducted at Hamad General Hospital in Qatar, aims to determine the renal involvement in all pediatric patients who were hospitalized with COVID-19 from March 1, 2020, to January 1, 2021.

Description

COVID-19 usually causes respiratory and gastrointestinal symptoms, Clinical features range from a common cold to severe diseases such as bronchitis, pneumonia, severe acute respiratory distress syndrome, multi-organ failure, and even death. SARS-CoV, MERS-CoV, and SARS-CoV-2 seem to less commonly affect children and to cause fewer symptoms and less severe disease in this age group compared with adults and are associated with much lower case-fatality rates. Coronaviruses are a large family of enveloped, single-stranded, zoonotic RNA viruses. Clinicians have observed many extrapulmonary manifestations of COVID-19, as hematologic, cardiovascular, renal, and gastrointestinal and hepatobiliary, endocrinologic, neurologic, ophthalmologic, and dermatologic systems can all be affected.

Acute kidney injury (AKI) is a frequent complication of COVID-19 and is associated with mortality. In adults, the incidence of AKI in hospitalized patients with COVID-19 ranged from 0.5% to 29% and occurred within a median of 7-14 days after admission. Studies from the USA have reported much higher rates of AKI. In a study of nearly 5,500 patients admitted with COVID-19 in a New York City hospital system, AKI occurred in 37%, with 14% of the patients requiring dialysis. AKI occurred at much higher rates in critically ill patients admitted to New York City hospitals, ranging from 78% to 90%. Of 257 adult patients admitted to ICUs in a study from New York City, 31% received renal replacement therapy (RRT). Furthermore, hematuria has been reported in nearly half of patients with COVID-19, and proteinuria has been reported in up to 87% of critically ill patients with COVID-19 (11). Hyperkalemia and acidosis are common electrolyte abnormalities seen in patients with COVID-19, even among patients without AKI. COVID-19 is also increasingly reported among patients with end-stage renal disease and kidney transplant recipients, with higher mortality rates than those seen in the general population.

Children and adolescents with COVID-19 fare considerably better than adults, with mortality rates in pediatric patients (age <18 years) of less than 1% reported in early studies . The most common clinical features in children described in the literature are fever, dry cough, and pneumonia . However, multisystem involvement is increasingly being recognized, including the development of hyperinflammatory shock.

In other studies, acute kidney injury has been reported in adult patients with COVID-19, with a high prevalence across inpatient admissions (7%) and admissions to adult intensive care units (ICUs; 23%), as first reported in Wuhan, China . In adult patients with COVID-19, acute kidney injury is related to increased mortality risk, even after adjustment for age, sex, and comorbidities. In addition, a large proportion of adults have proteinuria (44%) and hematuria (27%) at presentation, despite an elevated serum creatinine prevalence of only 16% .

In children, there is scanty data compared to adults, Douglas et al studied 52 pediatric patients (ages 0-16 years) admitted to Great Ormond Street Hospital for Children NHS Foundation Trust (London, UK) since March 25, 2020, with confirmed severe acute respiratory syndrome coronavirus infection, and diagnosed by either a positive PCR result or seropositivity. Of the 52 inpatients, 24 (46%) had a serum creatinine greater than the upper limit of reference interval (ULRI), 22 [42%] had proteinuria, and hematuria was found in 40 [77%] patients. Qui and colleagues (18) did not find any renal dysfunction in 36 hospitalized pediatric patients (ages 0-16 years) with COVID-19 in China. Renal dysfunction defined by a serum creatinine greater than 110 mol/L or serum urea greater than 7 mmol/L.

This retrospective, exploratory, descriptive study aims to determine the renal involvement in all pediatric patients who were hospitalized with COVID-19 in Qatar.

Details
Condition Coronavirus Infection, Renal Failure, Acute renal failure, Nephropathy, Coronavirus, Kidney Disease (Pediatric), Pediatric Kidney Disease, Renal Impairment, Renal Dysfunction, Impaired Renal Function, AKI, Kidney Failure (Pediatric), Kidney Disease, Kidney Failure, COVID19, kidney insufficiency, renal insufficiency, acute kidney injury, acute kidney injuries
Treatment To determine the prevalence of renal dysfunction in hospitalized children with COVID19 in Qatar.
Clinical Study IdentifierNCT04788394
SponsorHamad Medical Corporation
Last Modified on25 March 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

Is your age less than or equal to 14 yrs?
Gender: Male or Female
Do you have any of these conditions: Renal Failure or Pediatric Kidney Disease or acute kidney injuries or AKI or Kidney Failure or kidney insufficiency or Kidney Disease or renal insuffi...?
Do you have any of these conditions: Kidney Disease (Pediatric) or Impaired Renal Function or Pediatric Kidney Disease or Kidney Failure or Nephropathy or Acute renal failure or Renal Fai...?
Do you have any of these conditions: AKI or acute kidney injury or Coronavirus or Renal Impairment or Kidney Failure (Pediatric) or Kidney Disease or Kidney Failure or Acute renal failure...?
Do you have any of these conditions: Coronavirus Infection or Coronavirus or Kidney Failure or acute kidney injuries or Impaired Renal Function or Pediatric Kidney Disease or Renal Impair...?
All pediatric patients with COVID-19 were admitted to Hamad Hospital from (0
to 14) years, using the electronic medical records (Cerner), over that time
period (from March 1, to January 1, 2021), with one of the following
Proteinuria: (1+) on dipstick analysis
Hematuria: 5 RBC/HPF
Sterile Pyuria: 5 WBC/HPF or 10 WBC/mm3 with negative urine culture (44)
Hypernatremia :> 145meq/l
Hyponatremia: < 135 meq/l
Hypokalemia :< 3.5meq/l
Metabolic acidosis (ph <7.35)
Elevated serum creatinine :> upper limit of reference interval (ULRI) values
Elevated serum urea: > 7 mmol/l
Urine specific gravity (SG) <1.003

Exclusion Criteria

Patient with previous chronic kidney diseases
Clear my responses

How to participate?

Step 1 Connect with a site
What happens next?
  • You can expect the study team to contact you via email or phone in the next few days.
  • Sign up as volunteer to help accelerate the development of new treatments and to get notified about similar trials.

You are contacting

Investigator Avatar
Name

Primary Contact

site
Name

Phone Email

0/250
Please verify that you are not a bot.

Additional screening procedures may be conducted by the study team before you can be confirmed eligible to participate.

Learn more

If you are confirmed eligible after full screening, you will be required to understand and sign the informed consent if you decide to enroll in the study. Once enrolled you may be asked to make scheduled visits over a period of time.

Learn more

Complete your scheduled study participation activities and then you are done. You may receive summary of study results if provided by the sponsor.

Learn more

Similar trials to consider

Loading...

Not finding what you're looking for?

Every year hundreds of thousands of volunteers step forward to participate in research. Sign up as a volunteer and receive email notifications when clinical trials are posted in the medical category of interest to you.

Sign up as volunteer

user name

Added by • 

 • 

Private

Reply by • Private
Loading...

Lorem ipsum dolor sit amet consectetur, adipisicing elit. Ipsa vel nobis alias. Quae eveniet velit voluptate quo doloribus maxime et dicta in sequi, corporis quod. Ea, dolor eius? Dolore, vel!

  The passcode will expire in None.
Loading...

No annotations made yet

Add a private note
  • abc Select a piece of text from the left.
  • Add notes visible only to you.
  • Send it to people through a passcode protected link.
Add a private note