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Kidney Week

Abstract: PO0033

Comparing COVID Acute Respiratory Distress Syndrome Patients on Extracorporeal Mechanical Oxygenation (ECMO) to Non-COVID Patients: Incidence and Effects of AKI

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Shivaraj, Kiran, Westchester Medical Center, Valhalla, New York, United States
  • Sridhar, Abhinaya, Westchester Medical Center, Valhalla, New York, United States
  • Kore, Shruti, Westchester Medical Center, Valhalla, New York, United States
  • Papademetriou, Demetrios, Elmhurst Hospital Center, Queens, New York, United States
  • Coritsidis, George N., Elmhurst Hospital Center, Queens, New York, United States
  • Chugh, Savneek S., Westchester Medical Center, Valhalla, New York, United States
Background

AKI has historically plagued those with ARDS and during the pandemic especially so with large resultant mortality rates. During the past year those centers so equipped offered ECMO to treat severe COVID pneumonia. We compared the non COVID ARDS requiring ECMO with patients with COVID pneumonia requiring ECMO. The aim of the study was to understand the difference in the renal outcomes and its effects of mortality and thereby help in prognostication.

Methods

This is a single center retrospective study where patients with COVID pneumonia needing ECMO in between March 2020 to April 2021 were compared with non COVID ARDS patients needing ECMO between April 2013 to April 2021 .The 2 groups were compared and risk ratio calculated for the incidence of AKI, the need for Renal replacement therapy (RRT) and the mortality associated with it.

Results

After excluding the patients who did not meet the criteria, 26 COVID patients treated with ECMO were compared with 22 patients with non COVID ARDS treated with ECMO. The median age of COVID group was higher (48 years vs 36 years) and the median number of days needing ECMO for the COVID group was higher (13 days vs 31 days). Incidence of AKI and the AKI needing RRT were similar in the 2 groups. The overall mortality in patients with COVID pneumonia was higher. Patients with COVID who developed AKI had 1.32 times the risk of mortality, which increased to 1.62 when RRT was needed.

Conclusion

This is a first study comparing the renal outcomes of COVID ARDS requiring ECMO and non COVID ARDS requiring ECMO. Even though the median age and the median number of the days on ECMO were higher for the COVID group , surprisingly the incidence of AKI and those needing RRT were similar. But there was a significantly higher mortality when patients on ECMO developed AKI and even higher for those on RRT. This could be attributed to the cytokine storm seen with causing a multiorgan dysfunction which can manifest in the form of AKI. Presence of AKI needs to be identified early and can be used for the prognostication in COVID pneumonia.