The Covid-19 emergency in Italy has exploded and created a difficult and challenging situation for the country and particularly for the sanitary service as a global.
We are experiencing an outbreak of infection of incredible proportion and all the professional involved in the care of all types of patients have been recruited to assist the new cases coming day by day to our observation, particularly among adults and older people.
The fear was very high for immune-depressed patients and particularly for the fragile population of children carriers of a transplant, taking multiple immunodepressive drugs and for other generally critical like those on dialysis or with several comorbidities: strict measures for home isolation, reduced access to the hospital and tele-monitoring were immediately adopted after case “one” in Italy was identified.
The Italian Society of Pediatric Nephrology (SINePe) is daily monitoring the situation acquiring data form all the Regions, all centers of Pediatric Nephrology and of Pediatrics involved in the care of these children: until today March 13th, 2020 no cases of Covid-19 infection were relevated.
We received many requests upon immunosuppressive therapy withdrawal: at the moment basing on the data obtained so far we have no evidences to recommend any modification of the ongoing therapy.
We strongly recommend however that strict measures of home isolation as well as reduction of hospital admittance of patient and visitors are taken.
Basing on the Italian experience we recommend moreover that sanitary professionals are efficiently protected and organized to work in team to avoid simultaneous coinfection of operators.
Some concerns finally were raised on the use of ACE-I: at the moment there are no strong evidences to recommend to interrupt the use of the drug in all patients however it might be cautious to withdraw ACE-I when used as a renoprotective or antiproteinuric, when feasible.
The Italian Society of Pediatric Nephrology continues to monitor the situation and will be happy to share any useful information.
Italian Society of Pediatric Nephrology on behalf of all the Italian pediatric nephrologists
Ana Teixeira Kjell Tullus Rezan Topaloglu