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COVID-19 disease among children and young adults enrolled in the North American Pediatric Renal Trials and Collaborative Studies registry

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Abstract

Background

Coronavirus disease of 2019 (COVID-19) has disproportionately affected adults with kidney disease. Data regarding outcomes among children with kidney disease are limited. The North American Pediatric Renal Trials Collaborative Studies Registry (NAPRTCS) has followed children with chronic kidney disease (CKD) since 1987 at 87 participating centers. This study aimed to evaluate the impact of COVID-19 among participants enrolled in the three arms of the registry: CKD, dialysis, and transplant.

Methods

This was a retrospective cohort study of COVID-19 among participants in the NAPRTCS CKD, dialysis, and transplant registries from 2020 to 2022. Where appropriate, t-tests, chi-square analyses, and univariate logistic regression were used to evaluate the data.

Results

The cohort included 1505 NAPRTCS participants with recent data entry; 260 (17%) had documented COVID-19. Infections occurred in all three registry arms, namely, 10% (n = 29) in CKD, 11% (n = 67) in dialysis, and 26% (n = 164) in transplant. The majority of participants (75%) were symptomatic. Hospitalizations occurred in 17% (n = 5) of participants with CKD, 27% (n = 18) maintenance dialysis participants, and 26% (n = 43) of transplant participants. Fourteen percent (n = 4) of CKD participants and 10% (n = 17) of transplant participants developed acute kidney injury (AKI), and a total of eight participants (one CKD, seven transplant) required dialysis initiation. Among transplant participants with moderate to severe illness, 40–43% developed AKI and 29–40% required acute dialysis. There were no reported deaths.

Conclusions

COVID-19 was documented in 17% of active NAPRTCS participants. While there was no documented mortality, the majority of participants were symptomatic, and a quarter required hospitalization.

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Data availability

The data that support the findings of this study are available from the authors but restrictions apply to the availability of these data, which were used under agreement with the North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS), and so are not publicly available. Data, however, may be available from the authors upon reasonable request and with permission from NAPRTCS.

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Acknowledgements

We would like to acknowledge the NAPRTCS study group and participants for making this research possible.

North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS) Principal Investigators

Michael Somers, Boston Children's Hospital

Annabelle Chua, Duke University Medical Center

David Hooper, Cincinnati Children's Hospital Medical Center

Gina-Marie Barletta, Phoenix Children's Hospital

Craig Belsha, Cardinal Glennon Children's Hospital

Paul Brakeman, UCSF Benioff Children's Hospital

Priya Verghese, Lurie Children's Hospital

Meredith Atkinson, Johns Hopkins University

Bradley Warady, Children's Mercy Kansas City

Sharon Bartosh, American Family Madison Wisconsin

Rita Swinford, University of Texas Health Science Center Houston

Rima Zahr, LeBonheur Children's Hospital

Tom Blydt-Hansen, Children's Hospital of British Columbia

Maha Haddad, Univeristy of California Davis

Sarah Kizilbash, University of Minnesota Masonic Children's Hospital

Kathy Lee-Son and Lyndsay Harshman, University of Iowa

Nadine Benador, Rady Children's San Diego

Marissa DeFreitas, University of Miami

Kera Luckritz, University of Michigan

Sahar Fathallah-Shaykh, Children's of Alabama

Jillian Warejko, Yale

Joseph Flynn, Seattle Children's Hospital

Jennifer Jetton, Children's Hospital Wisconsin

Hiren Patel, Nationwide Children's Hospital

Kimberly Czech, University of Illinois

Carl Cramer, Mayo Clinic

Amita Sharma, Massachusetts General Hospital

Vikas Dharnidharka, St. Louis Children's Hospital

Ashton Chen, Wake Forest University

Margret Bock, Children's Hospital of Colorado

Asha Moudgil, Children's National Medical Center

Rachel Milner, Arkansas Children's Hospital

Raoul Nelson, Primary Children's Utah

Kelsey Richardson, Doernbecher Children's Hospital

Marcela Del Rio, The Children's Hospital at Montefiore

Rita Sheth, Loma Linda University Medical Center

Deborah Kees-Folts, Penn State Children's Hospital

Siddarth Shah, Kosair Children's Hospital

Katherine Dell, Cleveland Clinic Children's Hospital

Sarah Swartz, Texas Children's Hospital

Sarah Twichell and Elizabeth Hunt, University of Vermont

Sharon Andreoli, Riley Children's Hospital

Christina Nguyen, Rainbow Babies and Children's Hospital

Dechu Puliyanda, Cedars-Sinai

Benjamin Laskin, Children's Hospital of Philadelphia

Carlos Araya, Nemours Orlando

Scott Sutherland, Stanford

Robert Woroniecki, SUNY Stony Brook

Maury Pinsk, Children's Hospital of Winnipeg

Erin Rademacher, Golisano Children's Hospital at the University of Rochester Medical Center

Diego Aviles, Children's Hospital New Orleans

Syed Kamal, Valley Children's Hospital

Amy Staples, University of New Mexico

Kenneth Lieberman, Hackensack University

Janusz Feber, Children's Hospital of Eastern Ontario

Samhar Al-Akash, Driscoll Children's Kidney Center

Jorge Ramirez, Arnold Palmer

Daniel McKenney, Peyton Manning Children's Hospital at St. Vincent

Alexandru Constantinescu, Joe Dimaggio Children's Hospital

Deogracias Pena, AdventHealth Medical Group Pediatric Nephrology at Orlando

Julia Steinke, Yi Cai, and Jason Thomas, Helen De Vos Children's Hospital

Author information

Authors and Affiliations

  1. Department of Pediatrics, The University of Vermont Robert Larner College of Medicine, Burlington, VT, USA

    Sarah Twichell

  2. Division of Nephrology, Department of Pediatrics, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA

    Isa Ashoor

  3. Division of Pediatric Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Sara Boynton

  4. Division of Pediatric Nephrology, Hypertension and Pheresis, Washington University School of Medicine & St. Louis Children’s Hospital, St. Louis, MO, USA

    Vikas Dharnidharka

  5. University of Minnesota, Minneapolis, MN, USA

    Sarah Kizilbash

  6. Schneider Children’s Medical Center Israel, Petach Tiqva, Israel

    Daniella Levy Erez

  7. Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Daniella Levy Erez

  8. Tel Aviv University, Tel Aviv, Israel

    Daniella Levy Erez

  9. Division of Nephrology, University of Washington School of Medicine, Seattle, WA, USA

    Jodi Smith

Authors
  1. Sarah Twichell
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  2. Isa Ashoor
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  3. Sara Boynton
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  4. Vikas Dharnidharka
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  5. Sarah Kizilbash
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  6. Daniella Levy Erez
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Consortia

on behalf of the NAPRTCS Investigators

  • Michael Somers
  • , Annabelle Chua
  • , David Hooper
  • , Gina-Marie Barletta
  • , Craig Belsha
  • , Paul Brakeman
  • , Priya Verghese
  • , Meredith Atkinson
  • , Bradley Warady
  • , Sharon Bartosh
  • , Rita Swinford
  • , Rima Zahr
  • , Tom Blydt-Hansen
  • , Maha Haddad
  • , Kathy Lee-Son
  • , Lyndsay Harshman
  • , Nadine Benador
  • , Marissa DeFreitas
  • , Kera Luckritz
  • , Sahar Fathallah-Shaykh
  • , Jillian Warejko
  • , Joseph Flynn
  • , Jennifer Jetton
  • , Hiren Patel
  • , Kimberly Czech
  • , Carl Cramer
  • , Amita Sharma
  • , Ashton Chen
  • , Margret Bock
  • , Asha Moudgil
  • , Rachel Milner
  • , Raoul Nelson
  • , Kelsey Richardson
  • , Marcela Del Rio
  • , Rita Sheth
  • , Deborah Kees-Folts
  • , Siddarth Shah
  • , Katherine Dell
  • , Sarah Swartz
  • , Elizabeth Hunt
  • , Sharon Andreoli
  • , Christina Nguyen
  • , Dechu Puliyanda
  • , Benjamin Laskin
  • , Carlos Araya
  • , Scott Sutherland
  • , Robert Woroniecki
  • , Maury Pinsk
  • , Erin Rademacher
  • , Diego Aviles
  • , Syed Kamal
  • , Amy Staples
  • , Kenneth Lieberman
  • , Janusz Feber
  • , Samhar Al-Akash
  • , Jorge Ramirez
  • , Daniel McKenney
  • , Alexandru Constantinescu
  • , Deogracias Pena
  • , Julia Steinke
  • , Yi Cai
  •  & Jason Thomas

Contributions

All authors contributed to the study conception and design. Material preparation and data analysis were performed by Sara Boynton and Sarah Twichell. The first draft of the manuscript was written by Sarah Twichell, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sarah Twichell.

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Twichell, S., Ashoor, I., Boynton, S. et al. COVID-19 disease among children and young adults enrolled in the North American Pediatric Renal Trials and Collaborative Studies registry. Pediatr Nephrol 39, 1459–1468 (2024). https://doi.org/10.1007/s00467-023-06241-0

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  • DOI: https://doi.org/10.1007/s00467-023-06241-0

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