Acute Kidney Injury Found in Children with COVID-19 & MIS-C

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Photo: The Feinstein Institutes for Medical Research

At the height of the coronavirus disease 2019 (COVID-19) pandemic, Northwell Health’s New York-based hospitals were among the first in the nation to report children diagnosed with the virus and related Multisystem Inflammatory Syndrome in Children (MIS-C). A team of investigators at the Feinstein Institutes for Medical Research and Northwell’s Division of Pediatric Nephrology recently published new research in the journal Kidney International which showed 11.8 percent of admitted children with COVID-19 and MIS-C developed acute kidney injury (AKI).

AKI is a sudden episode of kidney failure or damage, preventing waste from being filtered within the body. The retrospective study looked at 152 admitted patients (97 with acute-COVID-19 and 55 with MIS-C) less than 18 years of age between March 9 and August 13, 2020.

From the cohort, AKI occurred in 8.2 percent (eight patients) with COVID-19 and 18.2 percent (10 patients) with MIS-C. Patients with MIS-C and AKI had greater systolic dysfunction (80 percent) – or poor heart function – compared to those without AKI (49 percent). Additionally, the length of hospitalization increased by more than eight days for those patients with AKI.

“The sudden surge of COVID-19 in children and development of the mysterious MIS-C presented clinicians a new challenge during the height of the pandemic,” said Christine B. Sethna, MD, associate professor at the Feinstein Institutes for Medical Research and principal investigator on the paper. “It is important for doctors on the frontlines and those caring for these children after discharge to understand the connection between kidney injury and COVID-19 or MIS-C.”

Since the start of the pandemic, The Feinstein Institutes and Northwell Health’s Nephrology Division have led research nationwide to identify the risks and prevalence of kidney injury in COVID-19 patients. In May 2020, a team led by Kenar Jhaveri, MD, published results of the first large-scale COVID-19 study in Kidney International, which determined that 36.6 percent of hospitalized patients developed AKI. The latest study further draws a line to the virus’s devastating effects.

“This research reveals the risk of kidney injury, new clues into how COVID-19 progresses in children and untimely how we can treat the disease and its related complications,” said Abby Basalely, MD, assistant professor at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and first author.

Dr. Sethna and team suggest that further research in larger pediatric cohorts is needed to better characterize AKI risk factors in acute-COVID-19 and MIS-C.

“The dangers of kidney injury have been linked to adult COVID-19, but the risk for children has been less well defined,” said Kevin J. Tracey, MD, president, and CEO of the Feinstein Institutes. “Dr. Sethna’s work provides valuable insights into the disease so clinicians on the frontlines can better treat that vulnerable population.”

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