Introduction: The most of research to date indicates that children who have received a renal transplant are not at elevated risk of COVID-19 infection and generally have a mild illness course. Children are recognized as having a lower risk of severe COVID-19 infection than adults, although the most of pediatric renal transplant recipients had mild symptoms, severe illness and death have been reported in a small proportion of patients.
Materials and Methods: Between March 2020 and October 2021, COVID-19 was researched in kidney transplant recipients under the age of 19 who were followed at Başkent University Transplantation Center. We documented the clinical characteristics and prognosis of pediatric kidney transplant recipients with COVID-19 disease.
Results: We present 26 cases of COVID-19 infection from 215 pediatric patients with kidney transplantation. The average age of the patients was 14.2 (range 4-19), with 11 of them were female. The mean follow-up time after transplantation was 66.8 (range 6-148) months. In 16 patients (61.5%), fever was the most frequent symptom. Seventeen patients (65%) had mild respiratory symptoms such as cough, chest pain and loss of smell. Our 5 patients (21%) needed hospitalization. Four of them also developed acute kidney ınjury. One of these patients was hospitalized with a diagnosis of COVID-19 infection one week after being treated with IVIG and rituximab for acute antibody-mediated rejection. That patient developed significant lung disease and multi-organ failure. The second patient was a 5-year-old male who was admitted to the hospital due to diarrhea and required fluid and electrolyte replacement. Other hospitalized patients developed pneumonia but did not require intubation and recovered fully with antibiotic, antiviral and supportive therapy. Most of our patients (80.7%) had minor symptoms and recovered completely after receiving supportive treatment.
Conclusion: According to our experience, COVID-19 is generally overcome with mild symptoms in pediatric renal transplant patients. Due to new vaccines and new virus strains, the clinical picture may alter in coming years.