Abstract: PO0718
Clinical Characteristics and Outcomes in ESKD Patients with COVID-19 Infection in an Urban Community Hospital in Brooklyn, New York, During the Global Pandemic
Session Information
- COVID-19: Dialysis Patients
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Coronavirus (COVID-19)
- 000 Coronavirus (COVID-19)
Authors
- Zapata, Carlos M., Wyckoff Heights Medical Center, Brooklyn, New York, United States
- Rodriguez, Yariana Emma, Wyckoff Heights Medical Center, Brooklyn, New York, United States
- Akande, Olawale, Wyckoff Heights Medical Center, Brooklyn, New York, United States
- Ward, Laurie, Wyckoff Heights Medical Center, Brooklyn, New York, United States
- Bhat, Premila, Wyckoff Heights Medical Center, Brooklyn, New York, United States
Background
The impact of coronavirus disease 2019 (COVID-19) on individuals with End Stage Kidney Disease (ESKD) receiving maintenance hemodialysis (MHD) is unknown. This study aims to describe clinical characteristics and outcomes in a cohort of patients with ESKD receiving MHD hospitalized with confirmed COVID-19 infection in an urban community hospital during the New York City peak of the global COVID19 pandemic.
Methods
Cases with a diagnosis of ESKD and COVID-19 based on positive PCR testing results were identified from retrospective review of electronic health records for patients hospitalized between March 4, 2020 and April 30, 2020. Electronic health records were reviewed in order to obtain demographic data, presenting symptoms, laboratory values, medical management, and outcomes.
Results
29 patients with ESKD on MHD with confirmed COVID-19 infection were identified. 16/29 (55%) were over age 60 years, 20 (69%) were male and 14 (48%) were Hispanic. 18 (62%) had Diabetes and 26 (89%) were overweight or obese (BMI >25). All had hypertension. 68% were on Statin and 40% on ACE inhibitor or ARB at the time of admission. 25/29 (86%) were dialyzed via arteriovenous fistula or graft. The most common presenting symptoms were dyspnea (85%), cough (60%) and fever (28%). All initial chest radiographs showed abnormalities, with diffuse infiltrates on 21 (72.4%) and focal infiltrates on the remainder. All patients who required renal replacement therapy during hospitalization received conventional HD. 10 patients required mechanical ventilation during hospitalization (34%); all of these patients died. Overall, 13 patients (45%) died and 16 patients (55%) were discharged after a median of 6 and 7 days hospitalization, respectively. Three patients (10%) were readmitted during the period of observation. No significant associations were found between age, sex, race, or diabetes and mortality. Mechanical ventilation was the most consistent predictor of death.
Conclusion
45% mortality was observed in a small cohort of patients with ESKD on MHD with confirmed COVID-19 infection hospitalized during the peak of the global COVID-19 infection. This high mortality rate reinforces the need for social distancing and infection control measures to reduce transmission in this high risk population.
Funding
- Clinical Revenue Support