Incidence and Severity of Pediatric-Onset ANCA-Associated Vasculitis (AAV) Glomerulonephritis (GN) during the COVID-19 Pandemic: A Large Tertiary Center Experience

Background: During the SARS-CoV-2 virus global pandemic, there were concerns that changes in access to care would negatively impact both the timely diagnosis and severity of disease at presentation. This study sought to determine the incidence and severity of disease at presentation in patients with AAV seen in our center during the pandemic (03/2020-05/2023) compared to those seen prior to the pandemic (01/2017-2/2020). Methods: We retrospectively reviewed patients with AAV from 2017 to 2023. Abstracted data included patient demographics, clinical characteristics, durations of symptoms prior to presentation, clinical features on presentation, renal biopsy findings, and renal outcomes. Data were evaluated using standard descriptive statistics Results: In the study period, 29 patients were identified.Figure 1 shows the patient demographic data and clinical characteristics on presentation. The pre-pandemic cohort (N=12), 58% had MPA (N=7) and 42% GPA (N=5). Mean onset of symptoms to diagnosis of 1.5 months. At presentation, 68% had reno-pulmonary involvement, 16% ENT/Orbital, 8% isolated pulmonary, and 8% isolated renal disease.The pandemic cohort (N=15), 53% had MPA (N=8) and 47% GPA (N=7). Mean onset of symptoms to diagnosis was 1 month. Organ involvement in presentation: 53% renal-pulmonary, 20% isolated pulmonary involvement, 13% isolated renal disease, and 13% ENT/orbital (P=0.4). Conclusion: While there was a demonstrable 25% increase in the incidence in patients with AAV during the pandemic with a concurrent increase the frequency of both RPGN and CKD/ESKD (P=0.4), the duration of symptoms prior to presentation was not impacted. These data suggest that there was only a limited impact on access to care during the Pandemic. Factors that impacted disease severity and renal involvement need further investigation