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Kidney Week

Abstract: PO0784

Kidney Involvement and Outcome of COVID-19 Patients Admitted from a Federal Medical Facility

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Ahmad, Yahya Rauf, University of Kentucky Medical Center, Lexington, Kentucky, United States
  • Shea, Matthew, University of Kentucky Medical Center, Lexington, Kentucky, United States
  • Abdalbary, Mohamed Mamdouh, Mansoura University, Mansoura, Egypt
  • Kakani, Elijah, University of Kentucky Medical Center, Lexington, Kentucky, United States
  • Neyra, Javier A., University of Kentucky Medical Center, Lexington, Kentucky, United States
  • Mohamed, Amr El-Husseini, University of Kentucky Medical Center, Lexington, Kentucky, United States
Background

Correctional facilities face unique challenges with the COVID-19 pandemic. A COVID-19 outbreak was reported in the Federal Medical Center (FMC) in Lexington, Kentucky, a prison for inmates requiring medical and/or mental health care. We aimed to compare clinical characteristics and kidney related outcomes in inmates from this FMC to other COVID-19 hospitalized patients.

Methods

A total of 86 COVID-19 patients were admitted to our hospital between March 1st and June 1st, 2020. Among those, 37 patients were from the same FMC. We examined demographics, clinical and laboratory characteristics, along with the outcomes of this cohort and compared it to other COVID-19 non-prisoners. AKI was determined by KDIGO criteria.

Results

All inmates were men and their mean age was 59.8±10.6 years. The majority of them were white (60%) and required ICU admission (54%), while 39% of patients required mechanical ventilation. The prevalent comorbidities were hypertension (81%), obesity (62%), diabetes (41%) and coronary artery disease (CAD) (38%). Stage 3 CKD was present in 22% of inmates. The mean eGFR was 68±26 ml/min/1.73m2 at time of admission. Significant hematuria and proteinuria were found in 17% and 25% of patients, respectively. Hypertension, heart failure, CAD, COPD, hepatitis C infection, and AKI were more prevalent in the FMC cohort (P= 0.030, 0.001, 0.024, 0.001, 0.017, and 0.011, respectively). The difference in mortality rates was not statistically significant between groups (12% for inmates vs.17% for non-inmates, p=0.520). Incident AKI was higher in inmates vs. non-inmates (68% vs. 38%, p=0.006) and there was no difference in acute dialysis need (14% vs 12%, respectively). The overall mortality rates were higher in patients that required dialysis (80% vs. 6% for those who did not, p<0.001). The need for acute dialysis was independently associated with mortality in multivariable models.

Conclusion

Incidence of AKI was higher in hospitalized inmates with COVID-19 vs. non-inmates. The need for acute dialysis was strongly associated with mortality in overall COVID-19 hospitalized patients.