Kidney Week

Abstract: PO1236

Point-of-Care Ultrasound Findings Among Dialysis Patients with COVID-19

Session Information

• Hemodialysis and Frequent Dialysis - 4
  October 22, 2020 | Location: On-Demand
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Lohani, Sadichhya, University of Pennsylvania, Philadelphia, Pennsylvania, United States

Sadichhya Lohani,

• Potluri, Vishnu S., University of Pennsylvania, Philadelphia, Pennsylvania, United States

Vishnu S. Potluri,

• Lindsay-McGinn, Forrest F., University of Pennsylvania, Philadelphia, Pennsylvania, United States

Forrest F. Lindsay-McGinn,

• Morganroth, Jennifer, University of Pennsylvania, Philadelphia, Pennsylvania, United States

Jennifer Morganroth,

• Centeno, Claire A., University of Pennsylvania, Philadelphia, Pennsylvania, United States

Claire A. Centeno,

• Moore, Christy, University of Pennsylvania, Philadelphia, Pennsylvania, United States

Christy Moore,

• Teran, Felipe, University of Pennsylvania, Philadelphia, Pennsylvania, United States

Felipe Teran,

• Reisinger, Nathaniel C., University of Pennsylvania, Philadelphia, Pennsylvania, United States

Nathaniel C. Reisinger,

Background

Dialysis patients are vulnerable in the COVID-19 pandemic due to advanced age, comorbidities, and obligate travel with frequent healthcare contacts. Point-of-care cardiac and lung ultrasound (US) has been used to enhance the physical exam in dialysis patients and is a potent tool for assessment COVID-19, comparing favorably to computed tomography. Here we report findings of focused cardiac and lung US among dialysis patients in an acute care setting.

Methods

This is a cohort of dialysis patients who presented to our institution in Spring of 2020 with COVID-19. All patients started dialysis prior to the index acute care visit. Focused 5-view cardiac assessment and 12-zone lung US were obtained according to published protocols.

Results

25 patients were included. 88% were African American. 64% were female. Mean age was 61.96 and body mass index was 25.8 kg/m². 56% had history of heart failure, 28% lung disease. 15 (60%) were discharged with mean length of stay 10 days. 36% required invasive mechanical ventilation and 56% intensive care unit admission. 23 patients had cardiac US. 17 had an ejection fraction (EF) >55%, 3 had EF 30-55%, 1 had EF <30%. 23 had inferior vena cava (IVC) assessment, 18 had a normal or collapsed IVC, and 5 had a full, non-collapsing IVC. 3 had pericardial effusion. 4 had right-ventricular dysfunction. 25 completed anterior lung US zones and 12 also had posterior lung US. In at least 1 lung zone 16 (64%) had confluent B-lines, 16 (64%) consolidations, 16 (64%) isolated B-lines, and 17 (68%) pleural thickening. 8 had pleural effusions (3 bilateral). Figure 1 details lung US findings across anatomical zones.

Conclusion

We showed a high prevalence of thickened pleural lines, subpleural consolidations, and multifocal or confluent B-lines among dialysis patients with COVID-19. Most had a normal or collapsed IVC and intact cardiac function. Pleural and pericardial effusions were uncommon. More study is needed to determine whether US findings can help guide fluid management in dialysis patients.