Norovirus Gastroenteritis in Pediatric Kidney Transplant Recipients: A Pediatric Nephrology Research Consortium Study
Abstract
Background: Norovirus can cause debilitating diarrhea in transplant recipients. Herein, we describe the clinical course and complications of norovirus infection in children with a kidney transplant. Methods: Four transplant centers participated in this study. We included kidney transplant recipients who developed norovirus infection (confirmed by stool polymerase chain reaction or viral culture) between 1/1/2013 and 12/1/2019. Study variables are summarized as median and proportions. The estimated glomerular filtration rate (eGFR) was determined using the modified Schwartz equation. Acute kidney injury (AKI) was defined based on a change in eGFR per the pRIFLE criteria. Results: Our cohort included 40 patients, 33 (82.5%) requiring hospitalization. The median age at transplant was 5.4 years (IQR:2.2, 1.2). Thirty-one patients (77.5%) were white, and 26 (65.0%) were male. The median time to diarrhea onset after transplant was 1.9 years (IQR:0.8, 3.8). The median diarrhea duration was 16 days (IQR:6.0,41.5), and that of hospitalization was 3 days (IQR: 2.0,8.0). During the norovirus infection, 17.5% developed neutropenia, 15% had a urinary tract infection, 17.5% had BK DNAemia, and 20% had EBV DNAemia.
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 40 participants or records.
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