Abstract: FR-PO030
Clinical Characteristics and Outcomes of Critically Ill COVID-19 Patients That Required Continuous Renal Replacement Therapy With and Without Adjuvant Blood Purification
Session Information
- COVID-19: AKI Outcomes, Biomarkers, Treatments, Case Reports
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Coronavirus (COVID-19)
- 000 Coronavirus (COVID-19)
Authors
- Ortiz-Soriano, Victor M., University of Kentucky, Lexington, Kentucky, United States
- Carter, Stuart M., University of Kentucky, Lexington, Kentucky, United States
- Liu, Lucas Jing, University of Kentucky, Lexington, Kentucky, United States
- Chen, Jin, University of Kentucky, Lexington, Kentucky, United States
- Neyra, Javier A., University of Birmingham at Alabama, Birmingham, Alabama, United States
Background
oXiris use received EUA by the FDA as a blood purification adjuvant for COVID-19 critical illness. We evaluated clinical characteristics and outcomes of patients with COVID-19 critical illness that received CRRT with vs. without oXiris.
Methods
Single-center, retrospective cohort study of adult ICU patients with COVID-19 critical illness requiring CRRT (3/2020 to 4/2021). oXiris exposure was defined as a minimum use of 48 h within the first 72 h of CRRT initiation and use of at least 50% of time if the patient died within the first 72 h of CRRT. Data were analyzed with and without propensity-score (PS) matching and with PS-regression.
Results
114 critically ill COVID adults admitted to the ICU required CRRT during the study period. Of these, 11 patients used oXiris without meeting the definition of exposure and were excluded. Of the 103 remaining patients, 31 used oXiris and 72 did not. Mean (SD) age of the cohort was 60 (12) years, 66% were male, and 81% white. There were no differences in demographics between both groups. Similarly, there was no difference in baseline kidney function or prevalence of ESRD. Patients that received oXiris had more frequently sepsis (90% vs. 63%, p=0.004) and more frequently received IL-6 inhibitors but CRRT indications were similar in both groups, being the most common one fluid overload in about two-third of patients. Critical illness parameters including SOFA scores (median of 11 in both groups) and extracorporeal organ support (ECMO or mechanical ventilation) were also similar in both groups. Inpatient mortality was not different between both groups (74% in the oXiris group vs. 65% in the non-oXiris group, p=0.37). Further, 28-day ventilator, CRRT and ICU free-days were comparable in both groups. Similarly, kidney recovery rates were not different based on oXiris exposure. These results were consistent in all adjusted analyses. There were no circuit or filter related complications attributed to oXiris.
Conclusion
The use of oXiris as adjuvant treatment of blood purification during CRRT appears feasible and safe. We did not observe differences in mortality, kidney recovery, or resource utilization among patients exposed vs. non-exposed to oXiris. The clinical impact of oXiris needs to be further evaluated in interventional studies.