A new study has uncovered alarming associations between SARS-CoV-2 infection and several detrimental kidney outcomes in pediatric patients. This massive study, which included more than 1.9 million people, underscores the long-term health impact of COVID-19 among younger people. These findings highlight the importance for continued monitoring of kidney health in individuals infected with the virus.
The analysis included 1,900,146 children and adolescents, with a median age of 8.2 years. Among them, 487,378 had developed COVID-19. Notably, 49% of the participants were women. By comparing those who tested positive for the virus to the 1,412,768 who did not, researchers were able to identify significant health risks associated with SARS-CoV-2 infection.
Increased Risks for Kidney Issues
The research indicates a clear association between SARS-CoV-2 infection and an elevated risk for new-onset chronic kidney disease (CKD) stage II or higher. This higher risk was detected 28 to 729 days after infection. This results in a hazard ratio for the development of new-onset CKD stage II or greater of 1.17. This is accompanied by a confidence interval of 1.12-1.22.
Children and adolescents with preexisting CKD were at even greater risk for composite kidney outcomes. This held true in both the early phase, from 28 to 179 days, and the later phase, from 180 to 729 days post acute infection. The associated hazard ratios for these outcomes were 1.15 in the early phase (95% confidence interval 1.04 to 1.27). In the later phase, that hazard ratio was a bit lower at 1.14 (95% CI 1.06 to 1.22).
“Results of this study suggest that SARS-CoV-2 infection is associated with an increased risk of adverse kidney outcomes, including new-onset CKD and worsening kidney function, particularly among children with preexisting CKD or acute-phase AKI, underscoring the importance of long-term monitoring for kidney health in children and adolescents affected by COVID-19,” – The authors
Acute Kidney Injury and Long-term Consequences
The research demonstrated that patients with AKI in the setting of their COVID-19 infection had increased risk of subsequent adverse outcomes. This underscores the important long-term consequences of AKI in patients with COVID-19. These people demonstrated an increased likelihood of experiencing composite kidney outcomes. For one, they had a decrease in estimated glomerular filtration rate (eGFR) of ≥ 50%.
This alarming trend suggests that those with preexisting conditions or AKI during acute infection may require more vigilant monitoring and care to prevent severe complications such as dialysis or kidney transplantation.
Funding and Future Implications
The research was funded by grants from the National Institutes of Health. This funding is included in the Researching COVID to Enhance Recovery initiative. This support highlights the importance of documenting COVID-19’s lasting health impacts on younger people.
The pandemic is dynamic. This important study further emphasizes the critical responsibility the healthcare community has to be aware of the possible kidney dangers associated with COVID-19. We need to start designing monitoring strategies that will monitor children/adolescents for the long-term after recovering from the virus. This will enable clinicians to intervene in a timely manner if kidney complications develop.
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