Changing Face of Pediatric Acute Poststreptococcal Glomerulonephritis in the Pre and Post Pandemic Period: A Comparison Study

Abstract

Objective: Acute poststreptococcal glomerulonephritis (APSGN) is the leading cause of acute glomerulonephritis in children. APSGN often develops after pharyngitis due to the activation of antibodies and complement proteins to streptococcal antigens by an immune complex-mediated mechanism. In this study, we aimed to analyze APSGN patients diagnosed before and after the pandemic, with their demographic characteristics , clinical and laboratory findings. Material and Methods: In this study, patients diagnosed with APSGN in a tertiary children’s hospital between October 2022 and March 2023 were retrospectively analyzed. The patients were compared with a large cohort followed up with the same diagnosis between 2010-2022. The patients were divided into two groups: group I (n=153, pre-pandemic) and group II (n=28, post-pandemic). Clinical, radiologic, and laboratory findings were compared between the two groups. Results: The mean age at diagnosis in the group I (2010-2022) was 7.36±2.92 years, and in the group II 8.69±2.51 years. More than three-fourths of the cases [group I/group II; 106 (69.3%) / 21 (71.4%)] were male in both studies. As macroscopic hematuria was the most common finding in the group I, hypertension was the most common finding in group II. Complement 3 (C3) levels were significantly lower in the group I and C3 recovery time was significantly shorter in the group II. Five (19.4%) of patients in group I and only one patient in group II progressed to RPGN. Conclusion: The incidence of APSGN increased rapidly after the Covid-19 pandemic when the use of face masks was discontinued. Although the patients presented with a serious clinic, their prognosis was better.