Clinical Profile and Outcome of COVID -19 in Children with Pre-Existing Renal Disease

Background and Aim: Despite several studies about COVID-19, many factors remain unknown. Apart from pulmonary involvement, the other systemic association needs to be explored. Since information is lacking this study was conducted to see the impact of COVID-19 infection in children with kidney diseases. Methods: This retrospective study was carried out at Dhaka Shishu (children) Hospital and Square Hospitals Ltd from April 2020 to August 2020. All the admitted children below 18 years who had renal diseases and tested RT PCR positive for the SARS-COV-2 virus were included in the study. Data regarding patient’s demography, clinical presentation, hospital course, and outcome were collected from the hospital database and were analyzed. Results: Among the COVID-19 positive pediatric patients, the proportion of patient with a history of kidney disease were 12%. The commonest age group belongs to 6 -10 years with a female predominance. Nephrotic syndrome (50%) was the commonest primary renal etiology followed by acute kidney injury (26%). Along with COVID-19 related symptoms like fever (38%) and respiratory tract infection (31%), a good number of them remain asymptomatic (27%) during diagnosis. Hypertension (50%) and hematuria (35%) were the two prevailing clinical findings. Moreover, anemia (65%), and elevated creatinine (50%) were found surprisingly higher irrespective of the primary etiology. A better outcome was observed in children under 5 years. Conclusion: Covid -19 is frequent in patients with a history of kidney diseases and it may present with an atypical presentation like hypertension and or hematuria. Hence, clinicians should increase their awareness and concern to deal with COVID-19 infection among renal patients.