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Abstract: PO0032

Follow-Up Study of Survivors of Stage 2 or 3 In-Hospital AKI with or Without COVID-19

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Koraishy, Farrukh M., Stony Brook University Renaissance School of Medicine, Stony Brook, New York, United States
  • Chaudhri, Imran, Stony Brook University Renaissance School of Medicine, Stony Brook, New York, United States
  • Munir, Kiran, Stony Brook University Renaissance School of Medicine, Stony Brook, New York, United States
  • St Hill, Euclid Jerome, Stony Brook University Renaissance School of Medicine, Stony Brook, New York, United States
Background

Acute kidney injury (AKI) is a hallmark of hospitalized patients with Coronavirus Disease 2019 (COVID-19) and associated with in-hospital mortality. Recent data suggests glomerular filtration rate (GFR) continues to decline after discharge in COVID-19 AKI survivors, but there are very few reports describing the long-term post-discharge outcomes.

Methods

This is an ongoing prospective study of 161 survivors of KDIGO stage 2 or 3 AKI who were admitted at Stony Brook Medicine (SBM) for COVID-19 between March-June 2020. ‘CKD’ was defined as patient’s final outpatient serum creatinine (SCr) value remaining >10% or 50% above baseline (defined as the lowest SCr during hospitalization) and final GFR < 60 ml/min/1.73m2. CKD was divided into ‘incident’ and ‘progressive’ based on baseline CKD status. We also investigated the readmission rate with and without AKI and post-discharge mortality. A comparison cohort of 66 AKI survivors concurrently admitted to SBM who tested negative for COVID-19 were also analyzed for all outcomes.

Results

COVID-19 AKI survivors were more likely to be non-White, Hispanic, have a lower prevalence of baseline CKD and greater severity of illness (mechanical ventilation, acute respiratory distress syndrome, vasopressor use and greater length of hospital stay) during hospitalization compared to COVID-19 negative survivors (p ≤ 0.01). COVID-19 negative AKI survivors were more likely to have re-hospitalization (p =0.03), although no difference was noted in re-hospitalization with AKI among the 2 groups. 29 out of 161 (18%) of COVID-19 positive AKI survivors died after their discharge from COVID hospitalization as compared to only 1 out of 66 patients (1.5%) of the COVID-19 negative AKI survivors (p<0.001). 42 (26.1%) of COVID-19 positive and 17 (25.8%) of the COVID-19 negative patients had a SCr and eGFR measure > 90 days after discharge. COVID-19 positive AKI survivors (11.9-19.0%) had no difference in the rate of incident or progressive CKD compared with COVID-19 negative AKI survivors (17.6%).

Conclusion

COVID-19 positive survivors of Stage 2 or 3 in-hospital AKI were more likely to have greater severity of illness during hospitalization and greater post-discharge mortality compared to COVID-19 negative AKI survivors. We did not find a difference in the rates of incident or progressive CKD at 10 months follow-up.