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Abstract: FR-PO012

Assessing Fluid Management and Its Association With AKI in COVID-19 Patients

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Bhutta, Salman, Nassau University Medical Center, East Meadow, New York, United States
  • Munshi, Rezwan Fahim, Nassau University Medical Center, East Meadow, New York, United States
  • Fogel, Joshua, Nassau University Medical Center, East Meadow, New York, United States
  • Nehru, Narois, Nassau University Medical Center, East Meadow, New York, United States
  • Pellegrini, James R., Nassau University Medical Center, East Meadow, New York, United States
  • Lam, Eric H., Nassau University Medical Center, East Meadow, New York, United States
  • Gomez Paz, Sandra, Nassau University Medical Center, East Meadow, New York, United States
  • Rubinstein, Sofia, Nassau University Medical Center, East Meadow, New York, United States
Background

Managing fluid balance in COVID-19 patients can be challenging, particularly if they develop acute kidney injury (AKI). We study the relationship between fluid net input and output (FNIO) in patients with confirmed COVID-19 infection with development of AKI, time to development of AKI, in-hospital length of stay (LOS), and in-hospital mortality.

Methods

This is a retrospective study of patients (n=403) with confirmed COVID-19. Data for FNIO was from day 1 through day 10 or until development of AKI were recorded, whichever occurred first. Available FNIO data was calculated as a mean due to information not available for all days. Covariates included demographics, comorbidities, treatment, and management variables.

Results

Mean age was 58.1 (SD=16.5) years. There were 39.5% female and 53.1% Hispanic. Mean FNIO average was 612.2 (SD=747.4) mL. For the outcome variables, AKI occurred in 22.8%, in-hospital mortality occurred in 26.3%, mean days to AKI were 7.7 (SD=6.3), and mean LOS was 11.4 (SD=13.2) days. In the multivariate logistic regression analyses, increased FNIO mean was significantly associated with slightly increased odds for mortality (OR=1.001, 95% CI:1.00, 1.001, p=0.03) but was not significantly associated with AKI (p=0.82). In the multivariate linear regression analyses, increased FNIO mean was significantly associated with lesser days to AKI (B=-6.92*10-5, SE=<0.001, p=0.002) while FNIO mean was not significantly associated with LOS (p=0.75).

Conclusion

Increased fluid balance was associated with AKI development and increased mortality. Physicians should exercise caution with administering fluid in patients with COVID-19 to prevent such adverse outcomes.