The disease caused by coronavirus SARS-CoV-2 (COVID-19) can affect almost all organs of the human body, including kidneys. We conducted a one-center study to comprehensively analyze the effects of kidney involvement on the course and outcomes in patients hospitalized with COVID-19, depending on the estimated glomerular filtration rate (eGFR) at admission. Out of the 1958 patients, 1342 (68.54%) had eGFR ≥ 60 mL/min/1.73 m² (group A) and 616 (31.46%) had eGFR < 60 mL/min/1.73 m² (group B). Group B was additionally divided into subgroups B1, B2, and B3 based on eGFR. We found that mortality rates during hospitalization, as well as after 90 and 180 days, were much higher in group B than group A. The highest mortality was observed in the B2 subgroup with eGFR of 15–29. The mortality of B patients was associated with comorbidities, respiratory dysfunction, immunological impairment, and more frequent development of AKI. AKI had a negative impact on patients’ survival, regardless of the initial renal function. At discharge, 7.4% of patients had serum creatinine levels 30% higher, or more, as compared to admission. The disease course and outcomes in COVID-19 patients are associated with baseline eGFR; however, AKI during hospitalization is a more significant predictor of poor prognosis regardless of the initial renal function.

The high prevalence of autism spectrum disorder (ASD), the specificity of paediatric patients and the determination of their parents give rise to the growing interest of scientists in potential therapeutic approaches. There are multiple aetiological factors involved, and more will probably be discovered. Currently, the involvement of genetic and environmental factors in the aetiology is widely accepted. Growing evidence has been presented for the link between gut dysbiosis and autism. Analysing recent scientific reports, attention was drawn to the proportion and composition of gut microbiota in children with this diagnosis. These are mainly Bacteroidetes, Firmicutes and Actinobacteria, all of which were more abundant in children with ASD than in controls. In turn, children with ASD showed significantly higher counts of Bacteroides, Parabacteroides, Clostridium, Faecalibacterium and Phascolarctobacterium and lower percentages of Coprococcus and Bifidobacterium. If the initial hypotheses support microbial involvement in ASD-related symptoms, clinical trials with microbiota as a therapeutic target would be highly desirable. Recently, researchers have also been interested in faecal microbiota transplantation and microbiota transfer therapy. However, given the inconsistency in results between different centres, final conclusions cannot be reached. Differences in the composition of microbiota arise from, among others, the large age range of patients, which has a general impact on the variability of the microbiome composition over the years of life, environmental diversity with its dietary and cultural habits affecting the unique composition of the microflora, as well as food selectivity that is typically seen in ASD.

Cyclosporine is a selective calcineurin inhibitor used, among other areas, in pediatric gastroenterology as rescue therapy in the treatment of severe ulcerative colitis (ASUC—acute severe ulcerative colitis) in children. The introduction of systemic glucocorticosteroids (GCSs) has significantly reduced mortality in ASUC. However, it should be emphasized that long-term use of these drugs is limited due to the high risk of adverse effects observed during therapy and their limited efficacy. The role of cyclosporine as a second-line therapy is referred to as a ‘rescue therapy,’ which aims to alleviate the symptoms of ASUC, often avoiding life-threatening complications (including toxic megacolon) and postponing the need for urgent colectomy. If colectomy is necessary, this provides time to better prepare the patient nutritionally and psychologically for surgery and to await the effect of slower-acting thiopurine preparations or other chronic treatments; their effectiveness in achieving long-term clinical and endoscopic remission is limited. New therapeutic approaches include cyclosporine as an inducer, which acts as a bridge to new forms of therapy, such as biological drugs, which are used as maintenance preparations in patients. In pediatric patients, there is limited research in the literature on new strategies for the use of cyclosporine. The aim of this review is to assess current evidence on cyclosporine as induction or rescue therapy in pediatric ASUC and explore future integration with biologic and biosimilar strategies, emphasizing its evolving role as a bridging agent toward biologics and novel targeted therapies.