Abstract
The Coronavirus outbreak is a rapidly evolving pandemic, placing unprecedented strain on health-care systems. COVID-19 presents challenges for management of children with renal diseases, especially those receiving long-term immunosuppressive medications, including renal transplant recipients and those with chronic kidney disease and acute kidney injury requiring dialysis. Our preparedness for managing this vulnerable group of children is the need of the hour. The purpose of this article is to provide guidance to caregivers and health care personnel involved in management of children with renal diseases and to ensure patient well-being, while protecting staff from infection.
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Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, et al. Epidemiology of COVID-19 among children in China. Pediatrics. 2020 Mar 16. [Epub ahead of print]. Available from: https://pediatrics.aappublications.org/content/early/2020/03/16/peds.2020-0702.1. Accessed on May 14, 2020.
CDC COVID-19 Response Team. Coronavirus Disease 2019 in Children- United States, February 12–April 2, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:422–26.
Ministry of Health and Family Welfare, Government of India. COVID-19 INDIA. Available from: https://www.mohfw.gov.in/. Accessed on May 8, 2020.
Ma Y, Diao B, Xifeng L, Zhu J, Liang W, Liu L, et al. 2019 novel coronavirus disease in hemodialysis patients: Report from one HD center in Wuhan, China. Available from: https://www.medrxiv.org/content/10.1101/2020.02.24.20027201v2/. Accessed on April 12, 2020.
Alberici F, Delbarba E, Manenti C, Econimo L, Valerio F, Pola A, et al. A single center observational study of the clinical characteristics and short-term outcome of 20 kidney transplant patients admitted for SARS-CoV2 pneumonia. Kidney Int. 2020 Apr 9. [Epub ahead of print]. Available from: https://www.kidney-international.org/article/S0085-2538(20)30365-3/fulltext. Accessed on May 14, 2020
Columbia University Kidney Transplant Program. Early Description of Coronavirus 2019 Disease in Kidney Transplant Recipients in New York. J Am Soc Nephrol. 2020 Apr 21. [Epub ahead of print]. Available from https://jasn.asnjournals.org/content/early/2020/04/27/ASN.2020030375.long. Accessed on May 14, 2020.
Akalin E, Azzi Y, Bartash R, Seethamraju H, Parides M, Hemmige V, et al. Covid 19 and kidney transplan-tation. N Engl J Med. 2020 Apr 24 [Epub ahead of print]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7200055/pdf/NEJMc2011117.pdf. Accessed on May 14, 2020.
Ministry of Health and Family Welfare Directorate General of Health Services (EMR division). Revised guidelines on clinical management of COVID-19. Available from: http://www.mohfw.gov.in/pdf/RevisedNationalClinicalManagementGuidelineforCOVID1931032020.pdf/. Accessed on April 26, 2020.
Board of Governors in Supersession of the Medical Council of India. Telemedicine Practice Guidelines. Available from: https://www.mohfw.gov.in/pdf/Telemedicine.pdf/. Accessed on April 26, 2020.
Ministry of Health and Family Welfare Directorate General of Health Services (EMR). Guidelines on rational use of personal protective equipment. Available from: http://www.mohfw.gov.in/pdf/GuidelinesonrationaluseofPersonalProtectiveEquipment.pdf/. Accessed on April 26, 2020.
Ministry of Health and Family Welfare Directorate General of Health Services (EMR). SOP for reallocation of residents/PG students and nursing students as part of hospital management of COVID. Available from: https://www.mohfw.gov.in/pdf/COVID19SOPfordoctorsandnurses.pdf/. Accessed on April 26, 2020.
Indian Council of Medical Research. Recommendation for empiric use of hydroxychloroquine for prophylaxis of SARS-CoV-2 infection. Available from: https://icmr.nic.in/sites/default/files/upload_documents/HCQ_Recommendation_22March_final_MM_V2.pdf/. Accessed on April 26, 2020.
Wallace D, on behalf of BAPN. Information and guidance for children on hemodialysis, peritoneal dialysis and immune suppression (including renal transplants). Available from: https://renal.org/covid-19/paediatric-useful-information-resources/. Accessed on April 26, 2020.
For patients with CKD using immunosuppressive therapy. Available from: https://renal.org/stratified-risk-prolonged-self-isolation-adults-children-receiving-immunosuppression-disease-native-kidneys/. Accessed on April 25, 2020.
Liu Z, Xiao X, Wei X, Li J, Yang J, Tan H, et al. Composition and divergence of coronavirus spike proteins and host ACE2 receptors predict potential intermediate hosts of SARSCoV-2. J Med Virol. 2020 Feb 26. [Epub ahead of print]. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/jmv.25726. Accessed on May 14, 2020
Vaduganathan M, Vardeny O, Michel T, McMurray JJV, Pfeffer MA, Solomon SD. Renin-angiotensin-aldosterone system inhibitors in patients with Covid-19. N Engl J Med. 2020;382:1653–59.
Covid-19 clinical trials tracker. Available from: https://covidclinicaltrials.com. Accessed on April 26, 2020.
Indian Council of Medical Research. Testing Labs Details. Available from: https://icmr.nic.in/sites/default/files/upload_documents/Strategey_for_COVID19_Test_v4_09042020.pdf. Accessed on April 07, 2020.
Ministry of Health and Family Welfare. Revised Guidelines for Dialysis of COVID — 19 patients. Available from: https://www.mohfw.gov.in/pdf/RevisedGuidelinesforDialysisofCOVID19Patients.pdf. Accessed on April 26, 2020.
Schwierzeck V, König JC, Kühn J, Mellmann A, Correa-Martínez CL, Omran H, et al. First reported nosocomial outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a pediatric dialysis unit. Clin Infect Dis. 2020 Apr 27. [Epub ahead of print]. Available from: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa491/5825509. Accessed on May 14, 2020.
Shen Q, Wang M, Che R, Li Q, Zhou J, Wang F, et al. Chinese Society of Pediatric Nephrology and Chinese Medical Doctor Association of Pediatric Nephrology. Consensus recommendations for the care of children receiving chronic dialysis in association with the COVID-19 epidemic. Pediatr Nephrol. 2020 Apr 24. [Epub ahead of print]. Available from: https://link.springer.com/article/10.1007/s00467-020-04555-x. Accessed on May 14, 2020.
Naicker S, Yang CW, Hwang SJ, Liu BC, Chen JH, Jha V. The novel Coronavirus 2019 epidemic and kidneys. Kidney Int. 2020;97:824–28.
Al Rifai A, Sukul N, Wonnacott R, Heung M. Safety of arteriovenous fistulae and grafts for continuous renal replacement therapy: Michigan experience. Hemodial Int. 2018;22:50–55.
Davenport A. Alternatives to standard unfractionated heparin for pediatric hemodialysis treatments. Pediatr Nephrol 2012;27:1869–79.
Hiremath S, Topf JM. Transplant. Available from: http://www.nephjc.com/news/covidtx/. Accessed on April 07, 2020.
National transplant specific guidance for COVID-19. Available from: https://notto.gov.in/WriteReadData/Portal/News/711_1_FINAL_GUIDANCE_COVID-19_31.03.2020.pdf/. Accessed on April 22, 2020.
Guidance on the management of transplant recipients diagnosed with or suspected of having COVID19. Available from: https://bts.org.uk/wpcontent/uploads/2020/03/Clinical_management_transplant_recipients.pdf/. Accessed on April 07, 2020.
DESCARTES expert opinion regarding the management of immunosuppressive medication for kidney transplant patients during the COVID-19 pandemic. Available from: https://www.era-edta.org/en/wp-content/uploads/2020/04/Expert-opinion-on-ISD-in-Covid-19.pdf/. Accessed on April 07, 2020.
Characteristics of potential antiviral agents under evaluation for treatment of COVID-19. Available from: https://www.covid19treatmentguidelines.nih.gov/therapeutic-options-under-investigation/. Accessed on April 26, 2020.
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Vasudevan, A., Mantan, M., Krishnamurthy, S. et al. Managing Children With Renal Diseases During the COVID-19 Pandemic. Indian Pediatr 57, 641–651 (2020). https://doi.org/10.1007/s13312-020-1893-8
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DOI: https://doi.org/10.1007/s13312-020-1893-8