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Year : 2022  |  Volume : 5  |  Issue : 1  |  Page : 21-26

COVID-19 and anemia in children with nephrotic syndrome

1 Department of Pediatric Nephrology, Square Hospitals Ltd., Dhaka, Bangladesh
2 Department of Pediatric Nephrology, Dr. M. R. Khan Sishu Hospital and Institute of Child Health, Dhaka, Bangladesh
3 Department of Pediatric Nephrology, Chittagong Medical College Hospital, Chittagong, Bangladesh
4 Department of Pediatric Nephrology, Asgar Ali Hospital, Dhaka, Bangladesh
5 Department of Pediatric Nephrology, Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh
6 Child Health Research Foundation, Dhaka, Bangladesh

Correspondence Address:
Md Abdul Qader
18/F, Bir Uttam Qazi Nuruzzaman Sarak, West Panthapath, Dhaka-1205
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajpn.ajpn_30_21

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Context: Children with COVID-19 present with less severe disease and require fewer hospitalizations than adults. Our previous study on children with renal disease and COVID-19, which included predominantly children with nephrotic syndrome, found anemia in a significant number of participants. Aims: This study aimed at evaluating the risk factors of anemia in children with nephrotic syndrome presenting with COVID-19 and the influence of anemia on hospital outcome. Methods: This case–control study was conducted at five pediatric nephrology centers in two major cities of Bangladesh. Consecutive patients with nephrotic syndrome and positive polymerase chain reaction (PCR) for severe acute respiratory syndrome coronavirus 2 were included as cases, and subsequently, two cases of nephrotic syndrome with negative PCR were enrolled as controls. Participants who presented between April 2020 and December 2020 were included, and demographic data, clinical features, and laboratory parameters were retrieved from hospital records for analysis. Results: A total of 22 children with nephrotic syndrome were positive with COVID-19 and subsequently, 44 children were included as control. The median age was 6.4 years in the cases and 5.2 years among the control. Most children presented with the initial episode of nephrotic syndrome. The children in the case group had a significantly lower hemoglobin level than the controls, and anemia was associated with raised inflammatory markers. In multivariate analysis, female sex and impaired renal function was associated with lower hemoglobin, but anemia did not have effect on hospital outcome. Conclusions: Anemia in children can be multifactorial. Anemia in nephrotic syndrome associated with COVID-19 does not appear to influence length of hospital stay and outcome.

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