MO500: Increased Mortality and Readmission Rates Among Hospitalized Covid-19 Patients With Varying Stages of Chronic Kidney Disease

Abstract

Abstract BACKGROUND AND AIMS Chronic kidney disease (CKD) has been recognized as a highly prevalent risk factor for both the severity of coronavirus disease 2019 (COVID-19) and COVID-19 associated adverse outcomes. In this multicentre observational cohort study, we aim to determine the mortality and readmission rates of patients hospitalized for COVID-19 across varying CKD stages. METHOD We performed a multicentre cohort study among COVID-19 patients included in the Dutch COVIDPredict cohort consisting of hospitalized COVID-19 patients (PCR-confirmed or CORADS score >4). Seven groups of CKD were defined based on a previously reported medical history of CKD and pre-admission eGFR (CKD-EPI), which was also used to categorize CKD-stages. Patients without CKD were classified as controls. The primary outcome was a composite endpoint of all-cause mortality, readmission or palliative hospital discharge in a 12-week follow-up period. Logistic regression was used to adjust the association between CKD groups and primary outcome in a stepwise procedure for the following confounders: age, sex, ethnicity, number of comorbidities and designated COVID-19 treatment wave. RESULTS From March 2020 until July 2021, a total of 4151 hospitalized COVID-19 patients were included, of whom 389 had a history of CKD before admission. After adjusting for all confounding covariables, in patients with CKD stage 3a, stage 3b, stage 4 and patients with NTX, odds ratios of death and readmission compared with patients without CKD ranged from 1.96 to 8.94 (Fig. 1). CONCLUSION We demonstrate an evident increased 12-week mortality and readmission rate in patients with CKD stage 3a and 4. Besides justified concerns for kidney transplant patients, clinicians should also be aware of more severe COVID-19 outcomes and increased vulnerability in all CKD patients.