Renal Involvement in a Child with COVID‑19 Infection and its Management with CRRT

Bahare Yaghmaii, Fatemeh Nili, Zeinab Najafi, Fariba Cheloi, Mastaneh Moghtaderi

Abstract


Novel Coronavirus disease (COVID‑19) is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS‑CoV 2) presenting mainly as an acute respiratory illness with interstitial and alveolar pneumonia. It can also affect multiple organs such as the kidney, heart, intestinal tract, blood, and nervous system. We report a 10‑year‑old boy presenting with severe cough, tachypnea, retraction and respiratory distress, fever, myalgia, oliguria, and anuria thereafter. He had no history of diarrhea, vomiting, or a runny nose. Laboratory findings include leukopenia and lymphopenia. CRP, ESR, and procalcitonin levels were high, but serum LDH was normal. RT‑PCR test was positive. In the initial days of admission, he needed mechanical ventilation support due to ARDS and received antiviral drugs, renal replacement therapy, hemoperfusion, and other necessary supportive cares. Thirty‑five days later, he weaned from the ventilator and discharged from hospital. Two weeks later, COVID‑19 specific IgG was found in serologic test.

Keywords


Acute kidney injury; child; continuous renal replacement therapy; COVID‑19

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References


Cai J, Xu J, Lin D, Yang Z, Xu L, Qu Z, et al. A Case Series

of children with 2019 novel coronavirus infection: Clinical and

epidemiological features. Clin Infect Dis 2020:ciaa198. doi:

1093/cid/ciaa198.

Zhang Y. The Epidemiological Characteristics of an Outbreak of

Novel Coronavirus Diseases (COVID‑ 19) — China, 2020.

Chinese Journal of Epidemiology (by The Novel Coronavirus

Pneumonia Emergency Response Epidemiology Team) 2020.

Livingston E, Bucher K. Coronavirus Disease 2019 (COVID‑ 19)

in Italy. JAMA 2020 doi: 10.1001/jama.2020.4344.

CDC COVID‑ 19 Response Team. Severe outcomes among

patients with coronavirus disease 2019 (COVID‑ 19) — United

States, February 12–March 16, 2020. MMWR Morb Mortal

Wkly Rep 2020;69:343‑6.

Simon AK, Hollander GA, McMichael A. Evolution of the

immune system in humans from infancy to old age. Proc Biol

Sci 2015;282:20143085. doi: 10.1098/rspb.2014.3085.

Henry BM, Lippi G, Plebani M. Laboratory abnormalities in

children with novel coronavirus disease 2019. Clin Chem Lab

Med 2020;58:1135‑8.

Li Z, Wu M, Yao J, Guo J, Liao X, Song S, et al. Caution on

kidney dysfunctions of 2019‑nCoV patients. medRxiv 2020. doi:

1101/2020.02.08.20021212.

Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L,

et al. Kidney impairment is associated with in‑hospital

death of COVID‑19 patients. medRxiv 2020. doi:

1101/2020.02.18.20023242.

Arabi YM, Arifi AA, Balkhy HH, Najm H, Aldawood AS,

Ghabashi A, et al. Clinical course and outcomes of critically

ill patients with Middle East respiratory syndrome coronavirus

infection. Ann Intern Med. 2014;160:389‑97.

Prof. Claudio Ronco & Prof. Jean‑Louis Vincent, Hemoperfuison

including new sorbent cartridges designed to remove cytokines

and other circulating mediators should be considered facing

the sepsis like syndrome induced by cytokines, Feb. 6th, 2020,

comments on Lancet Respir Med 2020.