Acute Kidney Injury in COVID-19-associated Multisystem Inflammatory Syndrome in Children (MIS-C)

Background: Multisystem Inflammatory Syndrome in Children (MIS-C) is a recently identified entity in association with COVID-19. Acute kidney injury (AKI) has been widely reported in patients with primary COVID-19 infection. However, there is a paucity of literature regarding renal injury in MIS-C. We aim to characterize AKI in MIS-C in this cohort identified at a major children9s hospital in New York City during the COVID-19 pandemic. Methods: We conducted a retrospective cohort study of children 0-20 years old admitted to Morgan Stanley Children9s Hospital (MSCH) between April 18th and September 23rd, 2020. Patients were included if they met criteria for MIS-C based on CDC guidelines. All patients were evaluated for the presence of AKI, and AKI was staged according to KDIGO criteria. Results: Of the 57 children who met inclusion criteria, 46% (26/57) were found to have AKI. The majority of patients, 58% (15/26), were classified as KDIGO Stage 1. AKI was present upon admission in 70% of those identified. All patients had resolution of AKI at discharge, with 61% achieving recovery by day 2. One patient required dialysis. When compared to those without renal injury, the AKI cohort was older (p