{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T04:29:49Z","timestamp":1780547389960,"version":"3.54.1"},"reference-count":38,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Acute kidney injury (AKI) is increasingly recognised in children with acute COVID-19 and multisystem inflammatory syndrome in children (MIS-C), yet the long-term renal consequences in younger paediatric populations remain unclear. Most studies focus on acute illness or mixed-age cohorts, with limited data specific to children aged 0\u201312 years. Objectives: This study aimed to systematically identify, evaluate, and synthesise evidence on post-acute (\u226530 days) and long-term (\u226590 days) kidney outcomes following SARS-CoV-2 infection or MIS-C in children aged 0\u201312 years, including chronic kidney disease (CKD), eGFR decline, proteinuria, haematuria, hypertension, and need for kidney replacement therapy. Methods: We searched MEDLINE, Embase, CINAHL, and PubMed (December 2019\u201330 November 2025), following PRISMA 2020 guidelines and a registered PROSPERO protocol (CRD420251241949). Observational studies reporting kidney outcomes \u226530 days post-infection in children aged 0\u201312 years were included. Risk of bias was assessed using the Newcastle\u2013Ottawa Scale or ROBINS-I. Owing to heterogeneity and absence of \u22653 comparable datasets, a narrative synthesis was performed. Results: Seven studies met inclusion criteria (five MIS-C cohorts, two acute COVID-19 cohorts). Only a subset provided extractable data specific to children aged 0\u201312 years. Follow-up ranged from 30 days to 12 months; four studies reported outcomes \u2265 180 days. Across all studies, no incident CKD, sustained eGFR decline, or kidney replacement therapy were reported among children completing long-term follow-up; however, most long-term outcome data were derived from MIS-C cohorts with median ages around 8\u201311 years that included some adolescents, rather than exclusively children aged 0\u201312 years. One MIS-C study reported long-term hypertension in 14% of children. A cross-sectional Italian cohort of mild COVID-19 demonstrated hyperfiltration, proteinuria, and microhaematuria at ~3 months, though chronicity could not be assessed due to absence of baseline values. A large US EHR-based cohort identified increased CKD risk after COVID-19 in the broader &lt; 21-year population; however, 0\u201312-year-specific event counts were not reported, preventing quantitative synthesis for young children. Conclusions: Evidence on long-term kidney outcomes after SARS-CoV-2 infection in children aged 0\u201312 years remains limited, and only a small subset of studies provided extractable, age-specific data. On the other hand, MIS-C cohorts generally show favourable renal recovery, small sample sizes, lack of control groups, and short follow-up restrict confidence in these findings. Large paediatric EHR studies suggest potential long-term renal risk in broader paediatric populations, highlighting the need for age-stratified, prospective cohorts with serial eGFR, urine studies, and blood pressure assessments. Until definitive evidence emerges, structured renal follow-up may be warranted for children with AKI or MIS-C during COVID-19.<\/jats:p>","DOI":"10.3390\/children13010075","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T17:51:21Z","timestamp":1767376281000},"page":"75","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Long-Term Kidney Outcomes After SARS-CoV-2 Infection in Children Aged 0\u201312 Years: A Systematic Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4552-4513","authenticated-orcid":false,"given":"Saad","family":"Alhumaid","sequence":"first","affiliation":[{"name":"School of Pharmacy, University of Tasmania, Hobart 7000, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah Abdulrahman","family":"Alkhamees","sequence":"additional","affiliation":[{"name":"Pharmaceutical Care Department, King Abdulaziz Hospital, Ministry of National Guard Health Affairs, Al-Ahsa 36428, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nourah","family":"Al Dossary","sequence":"additional","affiliation":[{"name":"General Surgery Department, King Fahad Hofuf Hospital, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 36441, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anwar A.","family":"Almuslim","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6610-3675","authenticated-orcid":false,"given":"Rabab Abbas","family":"Majzoub","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine, King Faisal University, Al-Ahsa 31982, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qasem M.","family":"Alalwan","sequence":"additional","affiliation":[{"name":"Radiology Department, King Fahad Hofuf Hospital, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 36441, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Jassim","family":"Alsaeed","sequence":"additional","affiliation":[{"name":"Pharmaceutical Care Department, King Abdulaziz Hospital, Ministry of National Guard Health Affairs, Al-Ahsa 36428, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad Mohammed","family":"Aljowaisem","sequence":"additional","affiliation":[{"name":"Pharmaceutical Care Department, King Abdulaziz Hospital, Ministry of National Guard Health Affairs, Al-Ahsa 36428, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manahi Ayadh","family":"Alqahtani","sequence":"additional","affiliation":[{"name":"Pharmaceutical Care Department, King Abdulaziz Hospital, Ministry of National Guard Health Affairs, Al-Ahsa 36428, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulmohsen Ibrahim","family":"Alamer","sequence":"additional","affiliation":[{"name":"Pharmaceutical Care Department, King Abdulaziz Hospital, Ministry of National Guard Health Affairs, Al-Ahsa 36428, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muath Ibrahim","family":"ALDuhailan","sequence":"additional","affiliation":[{"name":"Pharmaceutical Care Department, King Abdulaziz Hospital, Ministry of National Guard Health Affairs, Al-Ahsa 36428, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawood Adnan","family":"Al Nasser","sequence":"additional","affiliation":[{"name":"Long-Term Care Department, Oyun City General Hospital, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 36312, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed S.","family":"Almuhanna","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa A.","family":"Al-Kamees","sequence":"additional","affiliation":[{"name":"Hazm Al-Mubarraz Health Center, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 36341, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan Ali","family":"Alhadab","sequence":"additional","affiliation":[{"name":"Ambulatory Transportation Administration, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 36421, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Ahmed","family":"Alsultan","sequence":"additional","affiliation":[{"name":"Medical Supply Store, Aloyoon General Hospital, Ministry of Health, Al-Ahsa 36312, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali N.","family":"Bukhamseen","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulaziz Abdullah","family":"Alabdullah","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kawther S.","family":"Alhaddad","sequence":"additional","affiliation":[{"name":"Pediatric Nursing Ward, Maternity and Children Hospital, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 36422, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murtadha A.","family":"Alhumaid","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Aloyoon General Hospital, Ministry of Health, Al-Ahsa 36312, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan M.","family":"Almusabeh","sequence":"additional","affiliation":[{"name":"Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 36421, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasin S.","family":"Almubarak","sequence":"additional","affiliation":[{"name":"Regional Medical Supply, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 36361, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rugayah Ahmed","family":"AlShayeb","sequence":"additional","affiliation":[{"name":"Pharmacy Department, King Fahad Hofuf Hospital, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 36441, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalal Ahmed","family":"Alnami","sequence":"additional","affiliation":[{"name":"Pharmacy Department, King Fahad Hofuf Hospital, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 36441, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaqoub Yousef","family":"Alatiyyah","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hereditary Blood Diseases Centre, Ministry of Health, Al-Ahsa 36422, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zainab","family":"Al Alawi","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology, College of Medicine, King Faisal University, Al-Ahsa 31982, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muneera","family":"Alabdulqader","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology Specialty, Pediatric Department, Medical College, King Faisal University, Al-Ahsa 31982, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e20200702","DOI":"10.1542\/peds.2020-0702","article-title":"Epidemiology of COVID-19 among children in China","volume":"145","author":"Dong","year":"2020","journal-title":"Pediatrics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1001\/jamapediatrics.2020.1948","article-title":"Characteristics and outcomes of children with coronavirus disease 2019 (COVID-19) infection admitted to US and Canadian pediatric intensive care units","volume":"174","author":"Shekerdemian","year":"2020","journal-title":"JAMA Pediatr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1111\/apa.15270","article-title":"Systematic review of COVID-19 in children shows milder cases and a better prognosis than 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