Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study

Matthew J Cummings; Matthew R Baldwin; Darryl Abrams; Samuel D Jacobson; Benjamin J Meyer; Elizabeth M Balough; Justin G Aaron; Jan Claassen; LeRoy E Rabbani; Jonathan Hastie; Beth R Hochman; John Salazar-Schicchi; Natalie H Yip; Daniel Brodie; Max R O'Donnell

The copyright holder for this preprint (which was not peer-reviewed) is the . https://doi.org/10.1101/2020.04. 15.20067157 doi: medRxiv preprint outcomes may be mediated by high levels of pro-inflammatory cytokines including IL-6 and dysregulated coagulation and thrombosis. 13, 14, 19 Continued investigation of these pathological processes and the utility of their biomarkers is needed given recent reports of corticosteroid use and ongoing clinical trials of IL-6-receptor antagonists among COVID-19 inpatients, as well as rapidly evolving guidelines for anti-coagulation in this population. 17, 20, 21 Consistent with unadjusted data from China, 3 Nearly 30% of patients in our cohort developed severe acute kidney injury requiring RRT during hospitalization. Consistent with emerging data from China, 23 nearly 90% of evaluated patients had proteinuria detected at hospital admission. The high frequency of RRT in our patient population has considerable implications for resource allocation given limited supplies of RRT machines and consumables, as well as staffing requirements, necessary to provide continuous or intermittent RRT to critically ill patients. As the general incidence and underlying mechanisms of severe COVID-19-related kidney injury remain poorly understood, 23 author/funder, who has granted medRxiv a license to display the preprint in perpetuity.