KIDNEY FUNCTION IN CHILDREN AND ADULTS HOSPITALIZED WITH CORONAVIRUS DISEASE 2019, RELATIONSHIP WITH URINARY BIOMARKERS AND GENETIC POLYMORPHISMS

E-Poster

https://storage.unitedwebnetwork.com/files/1099/ed038ef4cad90b7f2613acb4b2f55344.pdf

Abstract Title

First Name *

Elba

Last Name *

Medina

Co-author 1

Enrique José Antonio Robiou Vivero enriquerobiou@gmail.com HOSPITAL GENERAL DE MEXICO "DR. EDUARDO LICEAGA" Nephrology CDMX

Co-author 2

Antonio de Jesus Chida Romero jesuschidar@hotmail.com HOSPITAL GENERAL DE MEXICO "DR. EDUARDO LICEAGA" Internal Medicine CDMX

Co-author 3

Rafael Valdez Ortiz rafavaldez@gmail.com HOSPITAL GENERAL DE MEXICO "DR. EDUARDO LICEAGA" Nephrology CDMX

Co-author 4

ANGEL AUGUSTO PEREZ CATALAYUD gmemiinv@gmail.com HOSPITAL GENERAL DE MEXICO "DR. EDUARDO LICEAGA" INTENSIVE CARE UNIT CDMX

Co-author 5

BENJAMIN ANTONIO Rodriguez Espino RODRIGUEZESPINO@GMAIL.COM HOSPITAL INFANTIL DE MEXICO UNIDAD DE INVESTIGACION EN NEFROLOGIA Y METABOLISMO MINERAL OSEO CDMX

Co-author 6

MARIELA Esparza Garcia mareduos@yahoo.com.mx HOSPITAL INFANTIL DE MEXICO "FEDERICO GOMEZ" UNIDAD DE INVESTIGACION EN NEFROLOGIA Y METABOLISMO MINERAL OSEO CDMX

Co-author 7

SARBELIO MORENO ESPINOSA sarbelio.moreno@gmail.com HOSPITAL INFANTIL DE MEXICO UNIDAD DE INVESTIGACION EN NEFROLOGIA Y METABOLISMO MINERAL OSEO CDMX

Co-author 8

LOURDES MARROQUIN lulymarroquin@yahoo.com.mx HOSPITAL INFANTIL DE MEXICO PEDIATRIC CDMX

Co-author 9

LAURA ESCOBAR laurae@unam.mx FACULTAD DE MEDICINA, UNAM FISIOLOGIA CDMX

Co-author 10

LUIS VACA Ivaca@ifc.unam.mx INSTITUTO DE FISIOLOGIA FISIOLOGIA CDMX

Co-author 11

MARA MEDEIROS medeiro.mara@gmail.com HOSPITAL INFANTIL DE MEXICO FEDERICO GOMEZ LABORATORIO DE NEFROLOGIA Y METABOLISMO MINERAL OSEO CDMX

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

In COVID-19 disease, the kidneys are commonly affected; we can see abnormal dipstick or acute kidney injury (AKI), the latter of which is associated with mortality in children and adults. NGAL and Cystatin C are biomarkers that increase after kidney injury. Recognition of AKI is sometimes late; identification would help to improve the outcomes. There are few studies evaluating kidney function in children and adults. This work aims to describe the kidney function with creatinine and urinary levels of NGAL and cystatin C, hematuria, and/or proteinuria in patients hospitalized with COVID-19.

Methods

Prospective cohort study (July-September 2020), patients of any age hospitalized for COVID-19 were screened, including only confirmed cases and exclusion: Chronic Kidney Disease (CKD) stage 2 or more. Upon hospital admission and discharge, blood chemistry general, urinalysis, NGAL, and Cystatin C urinary were evaluated; genetic variants of the APOL1 gene were measured. Those patients identified with hematuria and/or proteinuria or acute kidney injury were analyzed.

Results

525 patients were screened, 378 children (40 included) and 162 adults (119 included). General characteristics, we found 42% of Children with COVID-19 had illness genetic y/o malformations and 49.4% of adults with obesity. The predominant symptom in children was fever (60%) vs. dyspnea in adults (73%). Adults had higher mortality, 31.1% vs 2.5% in children. Kidney function was evaluated by GFR and urinalysis, acute kidney injury and/or hematuria-proteinuria was identified (Table 1)

Table 1. Kidney function by eGFR and urinalysis of children and adults at the time of COVID-19 diagnosis and follow-up

Children

n=40

Adults

n=119

p<0.05*

eGFR

Initial (median, min-max)

Follow-up (median, min-max)

91.71 (17-189) IQR 34

145.73 (41.3-225.27) IQR 26.25†

97 (11-145) IQR 35

106 (13-140) IQR 22†

0.588

0.008ₑ*

Hematuria

Initial n(%)

Follow-up n(%)

11 (27.5)

7 (17.5)*

55 (46.2)

11 (9.3) *

0.076

0.263

Proteinuria

Initial n (%)

Follow-up n (%)

22 (55)

13 (32.5) *

85 (71.4)

9 (6.7) *

Conclusions

Children with COVID-19 had lower AKI than adults (22.5 vs. 45.4), as well as lower mortality.

Urinary cystatin C was higher at the admission visit than at subsequent visits in both children and adults, but the change was significant only in adults.

We found no relationship between APOL1 genetic variants and the severity of kidney damage.

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