Caracterización clínica del compromiso renal en pacientes pediátricos durante la pandemia SARS-CoV2 en el Hospital del Niño Dr. Francisco De Icaza Bustamante : de la epidemiología a la práctica clínica, período 2020 a 2022.

Abstract

Background: in the beginning, SARS-Cov2 infection was referred as an exclusively pulmonary disease, in the time with more cases appeared, extrapulmonary manifestations of COVID-19 began to be described, classifying it as a multisystem disease with predominantly endothelial involvement, with evidence of involvement of other organs such as the kidney, due to the virus's tropism through angiotensin-converting enzyme 2 (ACE2) receptors. Currently in Ecuador, there is no statistical information to determine the frequency with which this complication occurs. Methods: an Observational, cross-sectional, and retrospective study was performed in Dr. Francisco de Icaza Bustamante children hospital, since January 2020 until December 2022 with children diagnosed with COVID-19 and kidney injury. From 452 patients, only 121 met the inclusion criteria of the study, patients aged between 1 month and 17 years were included with a diagnosis of COVID-19 confirmed by PCR or COVID-19 antigen and with at least one serum creatinine determination and/or a complete urine study. Those with pre-existing kidney disease were excluded. Results: from 121 patients, 57.1% were male, with a higher prevalence for the age group 6 – 10 years of age, representing 49% of the total. The prevalence of renal involvement was 40.4% %, with the most frequent manifestations being: proteinuria in 63.3% of cases, hematuria in 38.8% of cases, related to glomerular damage and AKI; Increased creatinine was also evident in 6,1% of patients, arterial hypertension in 40.8% of cases. A mortality of 4.1% was found in patients with renal involvement. None required renal replacement therapy. Conclusions: in patients with COVID-19, acute kidney injury is a frequently observed complication. Early determination of acute kidney injury in hospitalized COVID-19 patients will allow timely management and improve the impact on prognosis.