CHRONIC KIDNEY DISEASE IMPACT ON CORONAVIRUS (COVID-19) INFECTION SEVERITY AND OUTCOMES IN CANCER PATIENTS

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E-Poster

https://storage.unitedwebnetwork.com/files/1099/1f102850d2a9ebeabd41fbdd465fbb3a.pdf

Abstract Title

First Name *

Cesar

Last Name *

Simbaqueba Clavijo

Co-author 1

Omar Mamlouk OMamlouk@mdanderson.org University of Texas MD Anderson Cancer Center Nephrology Houston

Co-author 2

Kodwo Dickson KBDickson@mdanderson.org University of Texas MD Anderson Cancer Center Hospital Medicine / Internal Medicine Houston

Co-author 3

Maria Franco-Vega MFranco@mdanderson.org University of Texas MD Anderson Cancer Center Hospital Medicine / Internal Medicine Houston

Co-author 4

Mark Knafl MKnafl@mdanderson.org University of Texas MD Anderson Cancer Center D3CODE Houston

Co-author 5

Hui Song hsong@mdanderson.org University of Texas MD Anderson Cancer Center D3CODE Houston

Co-author 6

Sreedhar Mandayam SAMandayam@mdanderson.org University of Texas MD Anderson Cancer Center Nephrology Houston

Co-author 7

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Cancer patients are most vulnerable to the significant illness and mortality from COVID-19 infection. There is limited data regarding the outcomes for patients with COVID-19 infection and varying cancer types, stages, and chronic kidney disease (CKD). The primary objective of this study was to evaluate the association between baseline kidney function and COVID-19 infection related outcomes, including mortality, ventilatory support, ICU stay, acute kidney injury (AKI) requiring renal replacement therapy (RRT), and prolonged hospitalization in cancer patients

Methods

Utilizing the Syntropy platform, as part of the D3CODE protocol at MD Anderson, we extracted data from adult cancer patients hospitalized within 30 days of COVID-19 infection between March 2020 and May 2021. Patient’s demographics, laboratories, comorbidities, and outcomes were collected. We used Kaplan-Meier analysis for survival estimates 30 days after COVID-19 infection diagnosis, and multivariate Cox Proportional cause-specific Hazard model regression to determine hazard ratios for major outcomes

Results

We identified 1113 patients. Median age was 62 years. 255 patients (22.9%) had CKD. Patient’s characteristics are summarized in table 1. Age (60.7 vs 58.6 years p=0.0221 ), presence of CKD (27.7% vs. 18.7% p=<0.001), hypertension (80.2% vs. 73.4% p=0.008), diabetes (61.9% vs. 55.1% p=0.0259), coronary artery disease (CAD) (19% vs.11% p=<0.001), and hematological malignancy (56% vs. 41.6% p=<0.001) were associated with severe disease requiring higher oxygenation/ventilation support (nasal cannula, high flow, non-rebreather, bipap, mechanical ventilation).

123 patients (11%) developed AKI, among which 34 (27.6%) required RRT. CKD and proteinuria were associated with higher risk of requiring RRT, OR, 3.14 (95% CI, 1.24-8) and OR, 2.5 (95% CI, 1.11-5.6), respectively, patients with CKD had prolonged hospital stay (> 30 days), 45% vs. 22.5% p=0.035.

Having CKD, history of cardiac arrhythmia, and recent checkpoint inhibitor therapy (ICI) within 90 days of COVID-19 diagnosis, were associated with higher risk of death, OR, 3.06 (95% CI, 1.11-8.4), OR, 1.9 (95%CI, 1.43-2.5), and OR, 1.66 (95%CI, 1.17-2.4), respectively.

Conclusions

Cancer patients with pre-existing CKD, had more severe disease and were more likely to develop AKI, needing RRT, after covid infection and had higher mortality. Vaccination is essential in this population to decrease the risk of severe COVID-19 disease

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