Renal Involvement in Children with COVID-19

Among pediatric patients, SARS-CoV-2 infection has been associated with mild symptoms for the most part. However, renal involvement has been reported in both children and adults with COVID-19. Yuri Márcio Campos, MD, and colleagues, performed a review of data regarding renal involvement in COVID-19, with a focus on the pathophysiology of acute kidney injury (AKI) in pediatric inflammatory multisystem syndrome temporally associated (PIMS-TS) with SARS-CoV-2 and the potential impact of SARS-COV-2 infection on kidney function. Data on patients with history of kidney disease, including nephrotic syndrome and chronic kidney disease, were reported.

Results were reported in Current Pediatric Reviews [doi: 10.2174/1573396317666210924121550]. The results of the review of articles on renal involvement in pediatric COVID-19 patients in PubMed and Scopus suggested that with the emergence of PIMS-TS with SARS-CoV-2, pediatric patients are at risk of severe COVID-19, with multi-organ involvement and dysfunction. Several systems are affected in PIMS-TS in addition to intense inflammation, resulting in AKI. Results of some studies proposed that kidney cells, including the podocytes, may be at risk of direct infection by SARS-CoV-2; high levels of ACE2, the virus receptor, are expressed on the membrane of such cells. There have  been reports of cases of glomerular diseases triggered by SARS-CoV-2 infection and relapses of previous renal diseases.“Further studies are necessary to establish risk factors for renal involvement in pediatric COVID-19 and to predict disease outcome,” the researchers said.