Providing Care to Patients with AKI and COVID-19 Infection: Experience of Front Line Nephrologists in New York.

Abstract

Governor Cuomo recently stated, “We will lose people, the virus takes the most vulnerable. The challenge is to make sure we don’t lose anyone else we could have saved.” Severe acute respiratory syndrome coronavirus 2, known as COVID-19, was first described in China in December 2019 (1). A global pandemic followed in the months to come, leading to devastating consequences. By April 26, 2020, COVID-19 had spread to >200 countries, infecting >2.9 million people, and resulting in >200,000 deaths globally (2). The suspected index case of COVID-19 infection leading to the New York City/Westchester outbreak was described in a man who became ill on February 22. By the third week of March, New York City had become an epicenter of the COVID-19 outbreak in the United States. Nearly 1 million Americans have been infected with the virus and New York accounts for 29% of these infections. Never in our lifetime have so many people fallen ill simultaneously. The rapid increase in hospitalizations has challenged the delivery of health care in unprecedented ways. AKI has been reported in up to 25% of patients with severe COVID-19 infection (3,4). The volume of patients with severe AKI in a single hospital poses unique challenges for the nephrologist including ( 1 ) infection prevention ( 2 ) workforce ( 3 ) dialysis resources, and ( 4 ) communication. We report our experience of providing care to hospitalized patients with AKI in the Bronx during the first month of the outbreak. Montefiore Medical Center (MMC), located in the North Bronx in close proximity to Westchester County, has been one of the main urban tertiary care centers for patients in New York City with COVID-19 infection. MMC’s two main campuses are the Moses and Weiler Hospitals. Moses Hospital is a 726-bed hospital with five intensive care units (ICUs) (47 beds) and Weiler …