NKF Clinical Digest - COVID-19
A message from our Chief Medical Officer
Welcome to the NKF Clinical Digest. This resource is an ongoing compilation of the latest clinical information regarding COVID-19, curated by NKF subject matter experts. Our goal is to make it easy for the interdisciplinary team to find current data on the implications of COVID-19 for people living with kidney diseases. The NKF Clinical Digest will also provide links to the most current patient resources and educational tools developed by NKF to support people living with kidney diseases through this crisis. This compendium of resources will also include information regarding NKF’s recent advocacy activities to improve the care and the safety of people living with kidney diseases. We hope that you find the NKF Clinical Digest – COVID-19 a valuable resource as you care for kidney patients during these extraordinary times.
– Joseph A. Vassalotti, MD
Chief Medical Officer, National Kidney Foundation
General information about COVID-19
A cross-sectional study of patients in the United States who received testing for any cause, and whose ordering physicians assigned them International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes associated with any of 6 cancers (breast, colorectal, lung, pancreatic, gastric, and esophageal), was performed from January 1, 2018, to April 18, 2020. Mean (SD) weekly numbers of newly diagnosed patients were compared between baseline period (January 6, 2019, to February 29, 2020) and the COVID-19 period (March 1 to April 18, 2020). The study included 278,778 patients, 258,598 (92.8%) from the baseline period and 20,180 (7.8%) from the COVID-19 period. During baseline, the mean (SD) weekly number of newly identified patients was 2,208 (335) with breast cancer, 946 (134) with colorectal cancer, 695 (88) with lung cancer, 271 (39) with pancreatic cancer, 96 (14) with gastric cancer, and 94 (14) with esophageal cancer.
An early prognosis factor that could be a key to determining who will suffer greater effects from COVID-19, and help clinicians better prepare for these patients, may have been uncovered by researchers at The University of Texas Health Science Center at Houston. In this study, the authors were seeking identify a prognostic factor that could aid hospital workers in managing COVID-19. They discovered evidence of a relationship between lymphocytopenia and disease severity in critically ill patients.
Public health & COVID-19
Mental health & COVID-19
Research on COVID-19 treatments
Pfizer And Biontech Conclude Phase 3 Study Of COVID-19 Vaccine Candidate, Meeting All Primary Efficacy Endpoints.
A prospective study of 19 hospitalized patients with severe COVID-19 (11 on supplemental oxygen and 8 on a ventilator) were given the selective bruton tyrosine kinase (BTK) inhibitor, acalabrutinib, off-label. Patients received 100 mg acalabrutinib either orally or via feeding tube twice daily for 10 days (patients on supplemental oxygen) or 14 days (ventilated patients). Acalabrutinib improved oxygenation in most of the patients, usually within 1-3 days, without signs of toxicity. C-reactive protein and IL-6 rapidly returned to normal in most patients, as did lymphopenia, in association with improved oxygenation.
Kidney disease & COVID-19
Dialysis & COVID-19
Ikizler TA. COVID-19 and Dialysis Units: What Do We Know Now and What Should We Do? Am J Kidney Dis. 2020 Mar 23. [Epub ahead of print].
Kliger AS, Silberzweig J. Mitigating Risk of COVID-19 in Dialysis Facilities. Clin J Am Soc Nephrol. 2020 Mar 20. [Epub ahead of print].
Kidney transplant & COVID-19
- Recommendation # 9A With AKI requiring CRRT dose protein at 2.0-2.5 gm/kg/d
- Recommendation # 9B Monitor and replace micronutrients in AKD on CRRT (especially zinc, iron, selenium, Vit D, Vit C)
NKF Advocacy during the COVID-19 pandemic
NKF has identified and been actively advocating on several key areas of concern for our community in the context of the COVID-19 pandemic:
NKF is also working with several partners to implement policies that:
- Accelerate patients' access to home dialysis
- Ensure timely implementation of kidney care payment models
- Ensure kidney patients and transplant patients can access greater-than-30-day supplies of critical prescriptions including immunosuppressive drugs
- Ensure that vulnerable home dialysis, transplant patients, and living donors can receive needed blood draws in their homes
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