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Abstract: PO0734

Outcomes of ESKD Patients Hospitalized with COVID-19

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Ng, Jia Hwei, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States
  • Hirsch, Jamie S., Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States
  • Wanchoo, Rimda, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States
  • Sachdeva, Mala, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States
  • Hong, Susana, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States
  • Sakhiya, Vipulbhai, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States
  • Jhaveri, Kenar D., Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States
  • Fishbane, Steven, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States

Group or Team Name

  • on Behalf of Northwell Nephrology Covid-19 Research Consortium
Background

Patients with ESKD have a dysregulated immune system and a higher annual mortality rate compared with the general population. We aimed to describe the clinical characteristics and compare the outcomes of patients with and without ESKD, among those hospitalized with COVID-19 disease.

Methods

We reviewed the health records for all patients hospitalized with Covid-19 between March 1, 2020 and April 27, 2020 from 13 hospitals in New York. Patients < 18 years or admitted to inpatient obstetrics service were excluded. ESKD diagnosis was defined using ICD-10 code and manual adjudication. Patients were followed up through May 27, 2020.

Results

Of 10,482 patients admitted with COVID-19, 419 (4.0%) had ESKD. Among patients with ESKD, 408 (97.4%) were on hemodialysis and 11 (2.6%) were on peritoneal dialysis. When comparing baseline characteristics of the two groups, patients with ESKD were older, were predominately of Black race, and had greater proportions of comorbid conditions.
The primary outcome was that patients with ESKD had a higher odds of in-hospital death than those without ESKD (rates, 31.7% vs 25.4%; OR 1.4, 95% CI 1.1 - 1.7). After adjusting for age, sex, race/ethnicity, the odds of in-hospital death remained higher in the ESKD group (adjusted OR 1.5, 95% CI 1.2 - 1.8). The ESKD group did not have a significantly higher odds of needing mechanical ventilation than the non-ESKD group in both the crude analysis and after adjustment for age, sex, race/ ethnicity. The odds of having a length of stay of >7 days was higher in the ESKD group compared to the non-ESKD group, in both the crude analysis and the adjusted analysis (OR 1.62, 95% CI 1.3 - 2.1; adjusted OR 1.6, 95% CI 1.3 - 2.1). The independent predictors for death for non ESKD patients were age,male gender,cancer,CHF, elevated BUN, low albumin and being on a ventilator. The independent predictors of death for ESKD patients were age, lymphopenia, low albumin and being on a ventilator. Black race was associated with lower risk of death..

Conclusion

ESKD patients had a higher rate of mortality compared to non-ESKD patients hospitalized with COVID-19. Black race was associated with a lower risk of death among ESKD patients compared to white patients.