P3.108: Renal Manifestations of COVID-19 in paediatric patients admitted to the Bustamante Hospital for Children: A Single Centre Retrospective Study

Background: During the COVID-19 pandemic extrapulmonary manifestations have become apparent in the paediatric population especially renal manifestations causing significant morbidity. The prevalence of same has been well documented outside of the Caribbean. We aim to describe the epidemiology and clinical features of patients admitted with COVID-19 infection and document the renal manifestations and prevalence of Acute Kidney Injury in COVID-19 infected patients admitted to hospital.

Methods: This was a retrospective descriptive study conducted at the Bustamante Hospital for Children between April 1st 2020 to April 1st 2023 which documented the renal manifestations of COVID-19 infection in children aged less than twelve years. Ethical approval was granted from the Mona Campus Research Ethics Committee and the South East regional Health Authority. Confirmation of COVID 19 infection was a documented positive test for SARS CoV-2 on real-time reverse transcriptase-polymerase chain or having positive COVID-19 antibodies. Those who fulfilled the inclusion criteria were identified via the Patient Administration System and a COVID-19 log from the Infectious Disease Department. Renal involvement was defined as the presence of acute kidney injury, haematuria, proteinuria or leukocyturia. A p value of ≤ 0.05 was considered statistically significant.

Results: 151 patients fulfilled the inclusion criteria. The prevalence of renal manifestations and AKI in hospitalized patients with COVID-19 are 15% and 7.3%, respectively. Patients with renal manifestations tend to be older, median age being 3 years while those < 1 year were more likely to not have any renal manifestations. Acute Covid-19 infection was more common in children < 1year old while MIS-C tend to occur in older children. Patients with MIS-C are noted to have a significantly higher occurrence of renal manifestations and AKI compared to the acute COVID-19 patients (p < 0.001). Also, patients known to have comorbidities were found to be more likely to be diagnosed with AKI and MIS-C (p=0.006). In addition, having a diagnosis of AKI is more likely to warrant PICU admission. (p < 0.001)

Conclusion: COVID-19 infection in the paediatric population is associated with renal manifestations such as AKI. The clinical sequalae may range from being asymptomatic to critically ill requiring intensive care.
Screening for renal manifestations is recommended in patients presenting with COVID-19 infection ultimately improving management and allows for early intervention.