Abstract: FR-PO1111
Outcomes of Patients with CKD and ESRD Hospitalized with COVID-19: A Retrospective Cohort Study in Michigan
Session Information
- COVID-19 - II
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Coronavirus (COVID-19)
- 000 Coronavirus (COVID-19)
Authors
- Khine, Justin, The University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, United States
- Hannoudi, Ghadeer N., Trinity Health, Livonia, Michigan, United States
- Sule, Anupam, Trinity Health, Livonia, Michigan, United States
- Wall, Barry M., The University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, United States
Background
A large patient cohort, multivariate regression models, and inverse probability of treatment weights (IPTWs) to determine the effect of kidney disease on mortality in hospitalized CoVID-19 patients.
Methods
6,737 hospitalized, SARS-CoV-2 positive patients from the South East Michigan CoVID Consortium dataset were analyzed for common dimensions of risk factors for increased mortality. Univariate, multivariate logistic regression, and IPTW propensity scoring models were used to reflect the effect of each variable on outcomes. IPTW models required patient population trimming to include patients only within the region of common support, thus less patients were analyzed in the fully adjusted (N=6,117) and IPTW (N=4131) models.
Results
Unadjusted models show significant increases in all outcomes in any level of renal disease. No association with increased mortality as a result of renal disease after adjusting for covariates. IPTW model finds that renal dysfunction infers longer duration of hospitalization, and average higher SOFA scores. In CKD patients, SOFA scores were 1.34 times higher (p<0.001) versus control patients. ESRD patients were hospitalized longer (IRR=1.19;p<0.001), and had higher SOFA scores (IRR=1.98;p<0.001) than control patients.
Conclusion
Here, we show that renal disease in of itself does not directly lead to increased mortality in CoVID-19 patients. Initial findings of increased mortality in CKD and ESRD patients may more likely be a result of chronic disease burden as shown by sequela comorbidities seen in CKD and ESRD patients.
Association between CKD/ESRD and Binary CoVID-19 Outcomes
| Model | N | Overall p-value | CKD vs Control | ESRD vs Control | ESRD vs CKD | |||
| RR (95% CI) | p-value | RR (95% CI) | p-value | RR (95% CI) | p-value | |||
| In-Hospital Death | ||||||||
| Unadjusted | 6737 | <0.001 | 1.72 (1.45-2.05) | <0.001 | 1.43 (1.02-2.00) | 0.038 | 0.83 (0.57-1.19) | 0.32 |
| IPTW | 4131 | 0.59 | 1.06 (0.85-1.33) | 0.61 | 0.79 (0.44-1.42) | 0.44 | 0.75 (0.4-1.39) | 0.35 |
| In-Hospital Death or Expected Death (Transfer to Hospice) | ||||||||
| Unadjusted | 6737 | <0.001 | 1.76 (1.52-2.03) | <0.001 | 1.23 (0.9-1.68) | 0.19 | 0.70 (0.50-0.98) | 0.036 |
| IPTW | 4131 | 0.95 | 1.01 (0.84-1.23) | 0.90 | 0.92 (0.52-1.66) | 0.79 | 0.92 (0.5-1.67) | 0.77 |
| Admission to ICU | ||||||||
| Unadjusted | 6737 | <0.001 | 1.31 (1.15-1.49) | <0.001 | 1.88 (1.58-2.25) | <0.001 | 1.43 (1.16-1.75) | 0.001 |
| IPTW | 4131 | 0.42 | 1.90 (0.76-1.07) | 0.25 | 1.10 (0.78-1.54) | 0.59 | 1.22 (0.83-1.75) | 0.31 |
| Total Duration of Hospitalization (days) | ||||||||
| Unadjusted | 6737 | <0.001 | 1.22 (1.15-1.29) | <0.001 | 1.53 (1.39-1.70) | <0.001 | 1.27 (1.12-1.41) | <0.001 |
| IPTW | 4131 | <0.001 | 1.03 (0.98-1.08) | 0.28 | 1.19 (1.12-1.27) | <0.001 | 1.16 (1.08-1.25) | <0.001 |
| Highest SOFA score recorded across inpatient stay | ||||||||
| Unadjusted | 5842 | <0.001 | 1.65 (1.52-1.79) | <0.001 | 2.53 (2.20-2.91) | <0.001 | 1.54 (1.32-1.79) | <0.001 |
| IPTW | 3682 | <0.001 | 1.34 (1.25-1.44) | <0.001 | 1.98 (1.80-2.18) | <0.001 | 1.47 (1.33-1.64) | <0.001 |