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Abstract: PO0738

Outcomes of Patients on Chronic Dialysis Hospitalized with COVID-19

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Chan, Lili, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Jaladanki, Suraj K., Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Kaufman, Lewis, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Sharma, Shuchita, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Leisman, Staci A., Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • He, John Cijiang, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Murphy, Barbara T., Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Coca, Steven G., Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Nadkarni, Girish N., Icahn School of Medicine at Mount Sinai, New York, New York, United States
Background

Preliminary reports find that patients with end stage renal disease (ESRD) on dialysis who test positive for SARS-CoV-2 have fewer symptoms and require less intensive care than expected. However, there are no reports regarding the outcomes of ESRD patients who are hospitalized with coronavirus disease 2019 (COVID-19).

Methods

This is a retrospective observational study of patients aged ≥18 years with laboratory confirmed COVID-19 admitted to the Mount Sinai Health System between February 27 and May 20, 2020. ESRD patients were identified by International Classification of Disease codes for ESRD. ESRD patients were propensity matched (5:1) to non-ESRD patients by age, gender, race/ethnicity, comorbidities, body mass index, and facility and week of hospital admission. Multivariate analysis was performed to test the association of ESRD with mortality after adjustment for age, diabetes, hypertension, stroke, coronary artery disease, and congestive heart failure.

Results

122 ESRD patients were admitted during the study period and matched to 610 non-ESRD patients from the same study period. Patients with ESRD were well matched on age, sex, race/ethnicity and most comorbidities except ESRD patients had a higher prevalence of diabetes (55% vs 43%, P=0.02) and hypertension (66% vs. 55%, P=0.03). ESRD patients had higher inflammatory markers of ferritin and procalcitonin. There was no significant differences in d-dimer, fibrinogen, C reactive protein, or interleukin-6 (Figure 1A). ESRD patients were significantly less likely to receive mechanical ventilation (3% vs. 10%, P=0.01) or be admitted to the intensive care unit (9% vs. 21%), and had similar in-hospital mortality (9% vs 13%, P=0.5). ESRD status was associated with lower odds of intubation and intensive care admission, but not significantly associated with mortality after adjustments for age and comorbidities (Figure 1B).

Conclusion

While ESRD patients had higher prevalence of comorbidities and higher inflammatory markers, they had similar in-hospital mortality as matched non-ESRD patients.