Page 89 - Abstract Book KONIKA 18

Nephrology

O-NEP-007
How COVID-19 Affects Children with Kidney Disease

Widdy Winarta, Henny A. Puspitasari, Reza Fahlevi, Nina D. Putri, Tartila Tartila,
Madeleine R. Jasin, Eka L.Hidayati
Department of Child Health, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital,
Jakarta, Indonesia
Abstract
Background Kidney disease is a significant risk factor for severe Coronavirus disease 2019 (COVID-19).
A hospital-based study in Jakarta showed 40% mortality rate in COVID-19 children with comorbidities,
including kidney disease. Studies investigating the clinical characteristics of children with kidney disease as
one of the most important risk factors for COVID-19 are lacking. Objective To analyse clinical characteristics
and factors associated with severity and mortality related to COVID-19 infection in children with kidney
disease. Methods A retrospective cohort study was performed by collecting clinical data of all paediatric
kidney disease patients diagnosed with COVID-19 based on WHO case definition. Data were collected
from inpatient and outpatient unit of Cipto Mangunkusumo General Hospital from September 2020 to
July 2021. Outcomes measured were severity of COVID-19, ICU admission and mortality. Results Thirty-
five events of COVID-19 infection were recorded in 33 children with kidney disease. Primary etiology
was mostly glomerular diseases (n=22/35). Eight patients-initiated haemodialysis and 9 patients had
worsening kidney function during infection. Severe covid, ICU admission, and death occurred in 10/35;
12/35; and 4/35 patients, respectively. Of those receiving immunosuppressants, 11/16 were not admitted
to ICU and 12/16 had mild-moderate COVID-19. Pneumonia [OR 1.6 (95%CI 1.005 to 2.456)] and lupus
nephritis [OR 28 (95%CI 2.2 to 361.2)] were significantly associated with mortality in this population.
Conclusion COVID-19 infections in this cohort were predominantly in glomerular kidney disease group.
Worsening kidney function and dialysis initiation may be seen during COVID-19 infection. Lupus nephritis
and pneumonia are associated with mortality.
Keywords: COVID-19; children; kidney disease; mortality

KONIKA XVIII Abstract Book 43