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Abstract: PO0778

COVID-19 in Patients with CKD in New York City

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Akchurin, Oleh M., Weill Cornell Medicine, New York, New York, United States
  • Biswas, Sharmi, Weill Cornell Medicine, New York, New York, United States
  • Greenbaum, Michaela, Weill Cornell Medicine, New York, New York, United States
  • Licona, Alexandra, Weill Cornell Medicine, New York, New York, United States
  • Choi, Justin J., Weill Cornell Medicine, New York, New York, United States
  • Choi, Mary E., Weill Cornell Medicine, New York, New York, United States
Background

Coronavirus disease 2019 (COVID-19) has affected millions of people, and several chronic medical conditions appeared to increase the risk of severe COVID-19. However, limited data are available about the outcomes of COVID-19 in patients with chronic kidney disease (CKD).

Methods

This was an observational study of patients with CKD at three affiliated hospitals in New York City who were diagnosed with COVID-19 by reverse-transcriptase polymerase chain reaction of nasopharyngeal swab specimens collected in the emergency departments between March 3rd and April 21st, 2020. We stratified patients into three groups: pre-dialysis CKD, dialysis, and transplant. Data are shown as median (interquartile range). Logistic regression was used to identify CKD characteristics associated with non-survival.

Results

Of the 372 confirmed COVID-19 patients with CKD, 182 were pre-dialysis, 149 were on dialysis, and 41 had functional kidney transplant. The median age of the pre-dialysis group was 75 (63-85) years, dialysis group 66 (58-74) years, and transplant group 63 (48-71) years. Men comprised 62.4% of the cohort. Baseline serum creatinine was 1.5 (1.2-2.2) mg/dL in the pre-dialysis group. By the end of the observation period, 78.5% of patients were discharged or had died. Of these patients, mortality was highest in the pre-dialysis group (26.9%), followed by dialysis (24.2%), then transplant (9.8%) groups. Almost half of the cohort was receiving ACE-inhibitors or ARBs pre-COVID-19, which was not associated with non-survival. In the pre-dialysis group, baseline serum phosphorus was associated with non-survival (OR 1.5 per each 1.0 mg/dL of increase in serum phosphorus). Anemia, defined as hemoglobin <10 g/dL, was also associated with non-survival (OR 3.1) in that group. Body mass index (BMI)<25 kg/m2 was paradoxically associated with non-survival (OR 2.7) in patients with pre-dialysis CKD.

Conclusion

Our data demonstrate that mortality in this cohort, particularly in patients with pre-dialysis CKD, was substantially higher than in the general population in New York City. Poorly controlled CKD complications, including CKD-mineral and bone disorder and anemia, as well as low BMI were associated with mortality. Ongoing control of CKD complications may serve as an opportunity to improve outcomes of COVID-19 in patients with CKD.

Funding

  • Other NIH Support