COVID-19 associated with onset nephrotic syndrome in a pediatric patient: coincidence or related conditions?
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BRIEF REPORT
COVID-19 associated with onset nephrotic syndrome in a pediatric patient: coincidence or related conditions? Amado Alvarado 1 & Gabriela Franceschi 1 & Evelin Resplandor 1 & Jeannethe Sumba 1 & Nelson Orta 2 Received: 15 July 2020 / Accepted: 23 July 2020 # IPNA 2020
Abstract Background COVID-19 is less frequent in children than in adults and affects the former less severely; despite the fact that respiratory symptoms are the most frequent, in some cases unusual manifestations can be seen. Case-diagnosis We present a 15-year-old boy who tested positive for SARS-COV-2 infection and onset of nephrotic syndrome, without antecedent of kidney disease and who had normal urine tests shortly before being affected by COVID-19. Conclusions The patient described in this report, who was admitted due to nephrotic syndrome and respiratory syndrome, tested positive for COVID-19. He, based on the data review by the researchers, is the first reported case of COVID-19 with simultaneous onset of complete picture of nephrotic syndrome. The presence of both diagnoses could be a coincidence or an unusual form of presentation of COVID-19. Keywords Covid-19 . Nephrotic syndrome . SARS-COV-2 . Proteinuria . Adolescent
Introduction The pandemic of coronavirus disease (COVID-19) represents a multi-faceted challenge for health systems across the globe, including on issues related to diagnosis. Respiratory manifestations are the predominant presentation of COVID-19 among symptomatic patients; additionally, it is relevant to emphasize that multiple organ involvement, including the gastrointestinal tract, central nervous system, cardiovascular system, liver, bone marrow, and kidney, has been reported in patients infected with SARS-CoV-2 [1, 2]. As to viral tropism, the lungs are not the only COVID-19 target, but the kidneys also may be involved in a significant percentage of infected patients, particularly in those severely affected [3]. When compared with adults, COVID-19 is less frequent in the pediatric population, and typically presents respiratory syndrome [1, 4]; however, the virus can produce unusual manifestations in children, e.g., Kawasaki’s disease and gastrointestinal syndrome, and
* Nelson Orta [email protected] 1
General Hospital, Ecuatorian Institute of Social Security, IESS, Quito, Ecuador
2
University of Carabobo, Valencia, Venezuela
epidemiological studies have shown that children are at lower risk of critical illness [1, 2, 5]. Information about COVID-19 in children with nephropathies is lacking; a report from Spain described 16 patients with chronic kidney diseases presenting mild respiratory symptoms and few radiological manifestations. Of these, glomerular filtration worsened in three, and two patients with steroiddependent nephrotic syndrome had relapse [6]. Isolated nephrological manifestations in COVID-19 have also been reported: hematuria in a pediatric case [7] and hematuria and albuminuria in critical patients, suggesting an association of COVID-19 with nephritis glomerular changes [8]. Nephri
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