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Abstract: PO0692

Association of Antiplatelet and Anticoagulation Therapy with Dialysis-Requiring AKI in Critically Ill Patients with COVID-19

Session Information

Category: Coronavirus (COVID-19)

  • No subcategory defined

Authors

  • Moses, Andrew A., Columbia University Irving Medical Center, New York, New York, United States
  • Assal, Amer, Columbia University Irving Medical Center, New York, New York, United States
  • Asadourian, Paul, Columbia University Irving Medical Center, New York, New York, United States
  • Bautista, Anson G., Columbia University Irving Medical Center, New York, New York, United States
  • Boyd, Rebekah, Columbia University Irving Medical Center, New York, New York, United States
  • Dershowitz, Lyle, Columbia University Irving Medical Center, New York, New York, United States
  • Gans, Aaron, Columbia University Irving Medical Center, New York, New York, United States
  • Ha, Catherine, Columbia University Irving Medical Center, New York, New York, United States
  • Mcmullen, Hannah Lacey, Columbia University Irving Medical Center, New York, New York, United States
  • Nattakom, Mary, Columbia University Irving Medical Center, New York, New York, United States
  • Perez, Olivia D., Columbia University Irving Medical Center, New York, New York, United States
  • Stonesifer, Connor, Columbia University Irving Medical Center, New York, New York, United States
  • Stringer, William S., Columbia University Irving Medical Center, New York, New York, United States
  • Xiong, Yuqing, Columbia University Irving Medical Center, New York, New York, United States
  • Shirazian, Shayan, Columbia University Irving Medical Center, New York, New York, United States
Background

Critically ill patients with COVID-19 have a high incidence of thrombotic complications and dialysis-requiring acute kidney injury (AKI-D). COVID-19 hypercoagulability has been implicated as a possible contributor to AKI-D. Our hypothesis is that pre-existing antiplatelet (APT) or anticoagulation therapy (ACT) is associated with a lower incidence of AKI-D in critically ill patients with COVID-19.

Methods

Records of patients with COVID-19 admitted to the ICU from March 13th -April 1st 2020 were reviewed. Exclusion criteria included ESRD status, and ICU discharge or death prior to 14 days of follow-up. Groups were divided based on APT or ACT prior to ICU admission. AKI-D was defined as initiation of renal replacement therapy (RRT) of any kind during the 14 days. Groups were compared using 2-tailed Fisher’s exact test and unpaired t tests.

Results

A total of 149 records were reviewed, and 98 patients were included (47 died and 4 discharged). Twenty-three patients (23.5%) were on APT or ACT and 39 (40%) required RRT. Table 1 compares characteristics by study group. Hypertension and cardiac conditions were significantly different between groups. Twelve (52%) of patients on APT or ACT required RRT and 27 (36%) not on either required RRT (p=0.22).

Conclusion

Pre-existing APT or ACT was not associated with AKI-D in critically ill patients with COVID-19 and 2 weeks of follow up. Our study confirmed a high incidence of AKI-D but was limited by significant differences in cardiac conditions between study groups. Future larger studies examining this association in groups with comparable cardiac conditions are needed.