ABSTRACT
Background: Coronavirus disease 2019 (COVID-19) emerged from China in late 2019 as a respiratory disease of unknown cause. A novel coronavirus 2019-CoV was implicated as the cause. A high proportion of patients goes into septic shock from COVID- 19infection and develop acute kidney injury (AKI) which often requiring continuous renal replacement therapy (CRRT). Clinical experience has suggested that these patients are hypercoagulable with studies showing increased rates of thrombosis. This complicates the administration of CRRT as this leads to more frequent clotting of the dialysis catheter and sequelae of blood loss, time off dialysis, and increased use of resources Methods: We retrospectively audited all patients admitted at our center from February to April 2020 who developed severe AKI requiring CRRT and compared the number of CRRT clotted in the first 7 days in COVID-19 negative (N = 49) and positive (N = 55) patients. Pediatric patients were excluded from this analysis. We also collected data on other variables which may influence rate frequency such as location of catheter, INR, and presence of systemic anticoagulation Results: We found that patients who tested positive for COVID-19 had a higher number of clotting events in the first 7 days of CRRT (3.51 vs 1.63, p < 0.00008). This population had higher incidence of AKI vs ESRD, number of pressor, and PEEP. Also, COVID 19 patients on anticoagulation has decreased clotting frequency compare to COVID 19 positive patients not on anticoagulation (2.7 vs 4.3, P <0.05) Conclusions: This data confirms our clinical experience that coagulopathy in COVID-19 positive patients lead to a greater incidence of CRRT clotting and the use of systemic anticoagulation was effective in reducing the number of clotting events.