Severity of SARS-CoV-2 infection in children with kidney disease undergoing immunosuppressive therapy
- VernacularTitle:接受免疫抑制治疗的肾脏病患儿感染新型冠状病毒后病情严重程度分析
- Author:
Yunfan ZHANG
1
;
Huanhuan YANG
1
;
Jun HUANG
1
;
Ai FENG
1
;
Guizhi XIA
1
;
Chengfeng WANG
1
;
Guangming CHEN
1
;
Xiaobin CHEN
1
;
Zengfeng WENG
1
;
Yi CHEN
1
;
Jinrong WU
1
;
Jingjing LIU
1
;
Yuen YANG
1
;
Yuzhen ZHANG
1
;
Jinfeng LIN
1
;
Yuxian TANG
1
;
Junyan CHEN
1
;
Xiaojing NIE
1
Author Information
- Publication Type:Journal Article
- Keywords: Child; Kidney diseases; Immunosuppression; Coronavirus infections; Cytokines
- From: Chinese Journal of Pediatrics 2025;63(5):529-534
- CountryChina
- Language:Chinese
- Abstract: Objective:To investigate the impact of immunosuppressive therapy on the severity of SARS-CoV-2 infection and cytokine levels in pediatric patients with kidney diseases.Methods:A retrospective analysis was conducted on the clinical data of 40 hospitalized pediatric patients who were diagnosed with SARS-CoV-2 infection at the 900th Hospital of PLA Joint Logistic Support Force from December 2022 to February 2023. Based on their immunosuppressive status prior to SARS-CoV-2 infection, these patients were categorized into immunosuppressive group and non-immunosuppressive group. Independent sample t-tests, Mann-Whitney U tests, and χ2 test were employed to compare the clinical baseline characteristics and laboratory data, the severity of SARS-CoV-2 infection, and the levels of cytokines between the 2 groups. Results:Among the 40 patients, 11 were in the immunosuppressive group (aged 13 (8, 14) years, 9 males and 2 females) and 29 in the non-immunosuppressive group (aged 2 (1, 4) years, 15 males and 14 females). In the immunosuppressive group, 2 were asymptomatic cases, 8 were mild cases, and 1 was moderate case, and there was no severe or critical cases. In the non-immunosuppressive group, 8 were mild cases, 5 were moderate, 15 were severe cases, 1 was critical case, and no asymptomatic cases. The underlying diseases in the immunosuppressive group included nephrotic syndrome (6 cases), IgA vasculitis nephritis (2 cases), lupus nephritis (1 case), post-renal transplantation (1 case), and renal failure (1 case), with a mean total immunosuppression score (TIS) of (3.6±1.4) points. In the non-immunosuppressive group, 2 patients had a history of epilepsy, and the remaining 27 cases had no underlying conditions, all with TIS scores of 0. Compared to the children in the non-immunosuppressive group, those in the immunosuppressive group were more likely to exhibit asymptomatic or mild infection, with lower risks of severe disease, cytokine storm, fever, and cough, but a higher risk of fatigue ( OR=1.22, 2.66, 0.48, 0.12, 0.12, 0.13, 1.22; 95% CI 0.93-1.62, 0.99-7.15, 0.33-0.70, 0.03-0.57, 0.03-0.57, 0.03-0.65, 0.93-1.62; all P<0.05). The levels of cytokine IL-6, interferon-α and interferon-γ in the immunosuppressive group were all lower than those in the non-immunosuppressive group ( Z=2.23, 2.51, 2.92, respectively; all P<0.05). Conclusion:Pediatric patients with kidney diseases receiving appropriate immunosuppressive therapy may mitigate the severity of SARS-CoV-2 infection by suppressing the expression of cytokines.
