ESPN 53rd Annual Meeting

ESPN 2021


 
Incidence and outcome of SARS-CoV-2 infection in a kidney transplant pediatric recipients cohort from a single Center in Northern Italy
MARCO CAZZANIGA 1 MARTA BRAMBILLA 2 ANTONIO VERGORI 2 MARIA VIGANONI 1 STEFANIA ROTONDO 2 SARA TESTA 2 GIOVANNI MONTINI 3

1- PEDIATRIC NEPHROLOGY, DIALYSIS AND TRANSPLANTATION UNIT - FONDAZIONE IRCCS CA GRANDA OSPEDALE MAGGIORE POLICLINICO - UNIVERSITY OF MILAN, MILAN, ITALY
2- PEDIATRIC NEPHROLOGY, DIALYSIS AND TRANSPLANTATION UNIT - FONDAZIONE IRCCS CA GRANDA OSPEDALE MAGGIORE POLICLINICO, MILAN, ITALY
3- PEDIATRIC NEPHROLOGY, DIALYSIS AND TRANSPLANTATION UNIT - FONDAZIONE IRCCS CA GRANDA OSPEDALE MAGGIORE POLICLINICO, GIULIANA AND BERNARDO CAPROTTI, CHAIRS OF PEDIATRICS, DEPARTMENT OF CLINICAL SCIENCES AND COMMUNITY HEALTH, UNIVERSITY OF MILAN, MILAN, ITALY.
 
Abstract:

ObjectivesTo investigate the incidence and clinical outcomes of SARS-CoV-2 infection in pediatric kidney transplant (KT) recipients.

Methods: From March 2020 to April 2021, transplanted patients aged <21 yrs, routinely managed in our Center that underwent nasopharyngeal real time-polymerase chain reaction (RT-PCR) test to detect SARS-CoV-2 infection, were studied. Tests were performed according to clinical and/or epidemiological criteria. 

Results: 100 patients were enrolled; median age was 15.7 (2.2-20.8) years; median time from KT was 2.8 (0.0-16.6) years, including 20 patients enrolled at the KT. All patients were on maintenance immunosuppressive (IS) therapy (corticosteroids, CNI and anti-proliferative agents). 57 (35 males) pts were included according to the inclusion criteria and underwent at least one RT-PCR test, with a total of 110 swabsperformed. Indications were 43 for symptoms suggestive for SARS-CoV-2 infection, 24 for contact tracing, 40 for screening at hospitalization and 3 for positivity at serological Rapid Test. Overall, 12 (10.9%) tests were positive: two (4.6%), eight (33,3%), one (2,5%) and one (33,3%) for each criteria listed above, respectively. 

Among positive patients (6 males), 4 were asymptomatic (33.3%), 7 presented fever (58.3%), 2 upper respiratory tract symptoms (16.7%), 1 diarrhea (8.3%), 1 headache (8.3%), and 3 osteo-muscular pain (25%). None showed KT dysfunction. Mean duration of symptoms was 2.4 days. No patients required specific treatment (except for antipyretics) or IS reduction; no one was admitted to hospital. Median duration of RT-PCR positivity was 17 (2-31) days. 

Conclusions: Our data show that renal transplanted pediatric patients, even if immunosuppressed, are at low risk of clinically relevant COVID-19 as healthy age-related population. On the other hand, our results differed substantially from those showed by Italian elderly SOT recipients that have an high incidence and even more early and high mortality rate (27%) [Trapani et al. - Am J Transplant. 2020; 00:1–13].