ESPN 53rd Annual Meeting

ESPN 2021


 
IMPACT AND SEROPREVALENCE OF SARS-CoV-2 INFECTION IN CHILDREN WITH CKD OR IMMUNOSUPPRESSION
FEDERICA ALESSANDRA VIANELLO 1 WILLIAM MORELLO 1 ANTONIO PIO MASTRANGELO 1 ENRICO WIDAL 2 ISABELLA GUZZO 3 LUIGI ANNICCHIARICO PETRUZZELLI 4 ANDREA PASINI 5 CHIARA BENEVENUTA 6 LAURA MARTELLI 7 ROBERTO DALLAMICO 8 MARCO MATERASSI 9 LISA CUSINATO 10 MARIO GIORDANO 11 GIUSEPPE PUCCIO 1 ROBERTO CHIMENZ 12 CIRO CORRADO 13 ELISA BENETTI 10 CARMINE PECORARO 4 LICIA PERUZZI 14 LAURA MASSELLA 3 GIOVANNI MONTINI 1

1- PEDIATRIC NEPHROLOGY, DIALYSIS AND TRANSPLANT UNIT, FONDAZIONE IRCCS Cà GRANDA, OSPEDALE MAGGIO POLICLINICO, MILAN, ITALY
2- DIVISION OF PEDIATRICS, DEPARTMENT OF MEDICINE, UNIVERSITY OF UDINE, UDINE, ITALY
3- NEPHROLOGY AND DIALYSIS UNIT, PEDIATRIC SUBSPECIALTIES DEPARTMENT, BAMBINO GESU` CHILDREN’S HOSPITAL, ISTITUTO DI RICERCA E CURA A CARATTERE SCIENTIFICO, ROME, ITALY
4- PEDIATRIC NEPHROLOGY AND DIALYSIS UNIT, SANTOBONO CHILDREN’S HOSPITAL, NAPLES, ITALY
5- NEPHROLOGY AND DIALYSIS UNIT, DEPARTMENT OF PEDIATRICS, AZIENDA OSPEDALIERO UNIVERSITARIA, POLICLINICO SANT’ORSOLA-MALPIGHI, BOLOGNA, ITALY
6- PEDIATRIC NEPHROLOGY UNIT, REGINAMARGHERITA CHILDREN’S HOSPITAL, AZIENDA OSPEDALIERO-UNIVERSITARIA CITTA` DELLA SALUTE E DELLA SCIENZA DI TORINO, TURIN, ITALY
7- PAEDIATRIC UNIT, PAPA GIOVANNI XXIII HOSPITAL, BERGAMO, ITALY
8- DEPARTMENT OF PEDIATRICS, AZIENDA PER LASSISTENZA SANITARIA N 5 FRIULI OCCIDENTALE, PORDENONE, ITALY
9- NEPHROLOGY AND DIALYSIS UNIT, MEYER CHILDREN’S HOSPITAL, FLORENCE, ITALY
10- PEDIATRIC NEPHROLOGY, DIALYSIS AND TRANSPLANT UNIT, DEPARTMENT OF WOMENS AND CHILDRENS HEALTH, UNIVERSITY HOSPITAL OF PADUA, ITALY
11- NEPHROLOGY UNIT, GIOVANNI XXIII CHILDREN’S HOSPITAL, BARI, ITALY
12- PEDIATRIC NEPHROLOGY AND RHEUMATOLOGY UNIT WITH DIALYSIS, AZIENDA OPEDALIERO-UNIVERSITARIA G. MARTINO, MESSINA, ITALY
13- PEDIATRIC NEPHROLOGY UNIT, CHILDREN’S HOSPITAL “G. DI CRISTINA,” AZIENDA DI RILIEVO NAZIONALE AD ALTA SPECIALIZZAZIONE. “CIVICO,” PALERMO, ITALY
14- PEDIATRIC NEPHROLOGY UNIT, REGINAMARGHERITA CHILDREN’S HOSPITAL, AZIENDA OSPEDALIERO-UNIVERSITARIA CITTA` DELLA SALUTE E DELLA SCIENZA DI TORINO, TURIN, ITALY
 
Introduction:

 Italy was one of the most affected Countries by COVID-19 pandemic. Children with immunosuppression and chronic kidney disease (CKD) are considered at greater risk of infections. We aimed to assess the clinical impact and the seroprevalence of SARS-CoV-2 infection in an Italian cohort of children with CKD or immunosuppression.

Material and methods:

The Italian Society of Pediatric Nephrology performed a nationwide observational study to identify patients with severe COVID-19, defined as death, admission to intensive care unit, mechanical ventilation, and the need to change immunosuppressive treatment. Patients aged <18 years and affected by glomerular disease requiring immunosuppression, CKD stages 3–5, dialysis, or kidney transplant were enrolled. Data were collected by a phone-based questionnaire between April 13 and 24, 2020, and referred to the period February 20th - April 15th, 2020. To estimate the prevalence of SARS-CoV-2-IgG, 200 children were selected by random sampling from the initial population to be representative of the whole cohort and tested with COVID-19 Rapid Test (Model: GCCOV-402a) from July 15th to September 15th, 2020.

Results:

 A total of 1572 patients were included. No patients fulfilled the criteria for severe COVID-19. Compared with the healthy Italian pediatric population, a significantly higher percentage of patients underwent swab testing (5% versus 1%; p=0.005) but the percentage of positive tests was not significantly different (p=0.43). Only 3/1572 (0.19%) reported a previous SARS-CoV-2 infection documented by nasal swab. The serological testing for SARS-CoV-2-IgG was performed on 178/200 selected patients. A positive test was detected in 3/178 patients (1.7%). The percentage of children with kidney diseases who tested positive was not statistically different from the corresponding Italian healthy pediatric population (1.7% vs 2.2%).

Conclusions:

Children in the advanced stages of CKD or on immunosuppressive therapy have a low risk of SARS-CoV2 infection, similar to that of the healthy Italian pediatric population.