RESUMEN
ABSTRACT Objective: To describe cases of acute kidney injury (AKI) in children diagnosed with COVID-19, associated risk factors, clinical aspects and outcome of cases. Methods: Retrospective study, carried out in a pediatric hospital between March 2020 and September 2021, with patients with COVID-19 who were diagnosed with AKI, studying information present in medical records such as comorbidities, age, gender and use of nephrotoxic medications. Results: We studied 40 cases, and male individuals were significantly more affected (62.5%; p=0.025). AKI was a severe complication of COVID-19 infection, with 100% of the sample requiring admission to the Intensive Care Unit and 22.5% dying. The most prevalent comorbidities analyzed in this study were epilepsy, cerebral palsy and heart disease. Most patients were classified according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria as KDIGO 1 (42.5%), and required orotracheal intubation (67.5%). The frequency of use of nephrotoxic medications and need for dialysis was low, with percentages of 35 and 17.5%, respectively. Among the children who died, 70.4% had some comorbidity and 88.8% received invasive ventilation. Conclusions: AKI in children with COVID-19 infection is associated with severe conditions. Despite the severity, most patients were discharged alive from the hospital.
RESUMO Objetivo: Descrever casos de lesão renal aguda (LRA) em crianças diagnosticadas com COVID-19, associando fatores de risco, aspectos clínicos e evolução dos casos. Métodos: Estudo retrospectivo, realizado em hospital pediátrico entre março de 2020 e setembro de 2021, com pacientes com COVID-19 diagnosticados com LRA, que examinou informações presentes em prontuários como comorbidades, idade, sexo e uso de medicações nefrotóxicas. Resultados: Foram estudados 40 casos, sendo o sexo masculino significativamente mais acometido (62,5%; p=0,025). A LRA foi uma complicação grave da infecção por COVID-19, com 100% da amostra necessitando de internação na Unidade de Terapia Intensiva e 22,5% indo a óbito. As comorbidades mais prevalentes analisadas neste estudo foram epilepsia, paralisia cerebral e cardiopatia. A maioria dos pacientes foi classificada pelos critérios Kidney Disease: Improving Global Outcomes (KDIGO) como KDIGO 1 (42,5%) e necessitou de intubação orotraqueal (67,5%). A frequência de uso de medicamentos nefrotóxicos e necessidade de diálise foi baixa, com percentuais de 35 e 17,5%, respectivamente. Entre as crianças que faleceram, 70,4% apresentavam alguma comorbidade e 88,8% receberam ventilação invasiva. Conclusões: A LRA em crianças com infecção por COVID-19 está associada a quadros graves, apesar de a maior parte dos pacientes ter recebido alta hospitalar.
RESUMEN
OBJECTIVE: To describe cases of acute kidney injury (AKI) in children diagnosed with COVID-19, associated risk factors, clinical aspects and outcome of cases. METHODS: Retrospective study, carried out in a pediatric hospital between March 2020 and September 2021, with patients with COVID-19 who were diagnosed with AKI, studying information present in medical records such as comorbidities, age, gender and use of nephrotoxic medications. RESULTS: We studied 40 cases, and male individuals were significantly more affected (62.5%; p=0.025). AKI was a severe complication of COVID-19 infection, with 100% of the sample requiring admission to the Intensive Care Unit and 22.5% dying. The most prevalent comorbidities analyzed in this study were epilepsy, cerebral palsy and heart disease. Most patients were classified according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria as KDIGO 1 (42.5%), and required orotracheal intubation (67.5%). The frequency of use of nephrotoxic medications and need for dialysis was low, with percentages of 35 and 17.5%, respectively. Among the children who died, 70.4% had some comorbidity and 88.8% received invasive ventilation. CONCLUSIONS: AKI in children with COVID-19 infection is associated with severe conditions. Despite the severity, most patients were discharged alive from the hospital.
Asunto(s)
Lesión Renal Aguda , COVID-19 , Humanos , COVID-19/complicaciones , COVID-19/epidemiología , Lesión Renal Aguda/epidemiología , Lesión Renal Aguda/etiología , Masculino , Femenino , Niño , Estudios Retrospectivos , Adolescente , Preescolar , Factores de Riesgo , Lactante , Comorbilidad , SARS-CoV-2RESUMEN
Introdução e objetivo: Devido à pandemia do novo coronavírus, as crianças passaram a ficar mais tempo em casa, e essa mudança implicou diretamente nas manifestações de diversas doenças, inclusive da rinite. A rinite é a inflamação da mucosa causada, principalmente, por alérgenos, ocasionando sintomas como rinorreia, espirros, obstrução nasal, hiperemia conjuntival, prurido nasal e ocular. O objetivo deste estudo é avaliar as consequências do isolamento social nas crianças com rinite, a fim de compreender a modificação da doença nesse período. Métodos: O estudo é observacional transversal, com dados obtidos através de um questionário eletrônico, para pais e/ou responsáveis de crianças entre 5 e 12 anos. Resultados: No total de 116 respostas, 51,7% das crianças eram do sexo masculino, e a mediana de idade foi de 8,5 anos. Em relação à rinite, em 81% dos casos foi relatado melhora ou manutenção do quadro durante o período de isolamento social. Em um quarto da amostra houve piora na qualidade de vida dos pacientes. Os sintomas com maior piora foram espirros e prurido nasal, e o sintoma com maior melhora foi a rinorreia. Os desencadeantes de sintomas mais frequentes foram animais domésticos, tapetes e perfumes. O uso de medicamentos foi relatado em 59,4% dos casos, sendo que em 32,7% não houve prescrição médica. Conclusão: Os resultados encontrados evidenciaram que o isolamento social teve um impacto positivo em relação às manifestações clínicas da rinite na população estudada.
Introduction and objective: The COVID-19 pandemic required children to spend more time at home, and this change had a direct impact on the manifestations of various diseases, including rhinitis. Rhinitis is inflammation of the nasal mucosa caused mainly by exposure to allergens, resulting in symptoms such as rhinorrhea, sneezing, nasal obstruction, conjunctival hyperemia, and itchy eyes and nose. This study aimed to evaluate the consequences of social distancing in children with rhinitis in order to understand the changes in the disease pattern during the pandemic. Methods: We conducted a cross-sectional observational study with data obtained through an electronic questionnaire answered by parents and/or guardians of children aged 5 to 12 years. Results: From a total of 116 responses, 51.7% of children were male with a median age of 8.5 years. In 81% of cases, rhinitis symptoms improved or remained unchanged during the period of social distancing. In a quarter of the sample, there was a worsening of patients' quality of life. The symptoms with the greatest worsening were sneezing and nasal itching, and the symptom with the greatest improvement was rhinorrhea. The most frequent symptom triggers were pets, carpets, and perfumes. Medication use was reported in 59.4% of cases, with the use of over-the-counter medications in 32.7% of them. Conclusion: The results showed that social distancing had a positive impact on the clinical manifestations of rhinitis in the study population.