Abstract: PO0735
Outcome of Hospitalized ESRD-COVID-19 (C19) Infected Patients
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
- Navarrete, Jose E., Emory University, Atlanta, Georgia, United States
- Hosein, Darya, Emory University, Atlanta, Georgia, United States
- Franch, Harold A., Emory University, Atlanta, Georgia, United States
- Rahbari-Oskoui, Frederic F., Emory University, Atlanta, Georgia, United States
- Connor, Michael J., Emory University, Atlanta, Georgia, United States
- Lea, Janice P., Emory University, Atlanta, Georgia, United States
Background
Emory University affiliated hospitals serve the metro Atlanta area, where a significant number of C19 cases have ocurred. In this report we describe the outcomes of AKI and ESRD patients with confirmed C19 admitted to our health-system.
Methods
All patients seen by Emory Nephrology at 2 tertiary referral and one county hospital were categorized as ESRD if they required dialysis prior to C19 infection, or AKI if they developed acute kidney injury as a result of C19 infection. Outcomes of interest included patient survival and discharge from the hospital. Admission to Intensive care unit and use of mechanical ventilation were recorded. Comorbid conditions and outpatient use of medications were analyzed.
Results
From 3/1/20 to 5/26/20, 474 consecutive patients were seen in COVID-19 related consultation. 287 patients were considered PUI and eventually tested negative for C19. The remaining 187 patients were C19 positive by nasopharyngeal swab or tracheal aspirate and represent the study population for this report. There were 43 ESRD (23%) and 144 AKI (77%) patients.
Age (64 vs 63 years), gender (63 vs 66% males) ethnicity (86 vs 82% African-americans) and comorbid conditions were similar in AKI and ESRD patients. AKI patients were more likely to be admitted to ICU (83 vs 35%) and to require mechanical ventilation (73 vs 20%) compared to ESRD patients (p<0.05). Figure 1 presents the outcomes based on the type of renal disease at presentation. The eGFR of AKI patients at time of admission was 50±34 ml/kg/m2. 84 AKI patients required dialysis during their hospitalization (52.5%).
Conclusion
Patients with ESRD C19+ were less likely to require ICU admission or mechanical ventilation. Mortality of ESRD patients was 14% compared with 42% of AKI patients, (p<0.002). ESRD patients with C19 were also more likely to be discharged from the hospital compared to those with AKI.
Despite similar demographics and co-morbidities, hospitalized C19 AKI patients had worse mortality than those receiving chronic dialysis.