S1171 MELD-Na Score Is Prognostic of Illness Severity in COVID-19 Patients

INTRODUCTION: Prognostic markers are needed to understand the disease course and severity in patients with Covid-19, a viral respiratory illness that causes systemic symptoms However, there is no model to date that evaluates the complexity of this illness We hypothesized that the MELD-Na score would be associated with disease severity in patients with Covid-19 METHODS: This is an IRB approved, retrospective, single institution, cohort study that analyzed patients admitted to a community academic hospital with the diagnosis of Covid-19 between March, 1st 2020 and June 11th, 2020 The primary outcome was mortality at 30 days based on MELD-Na score calculated at the time of admission Secondary outcomes included the development of an Acute Kidney Injury (AKI), need for hemodialysis (HD), need for vasopressor hemodynamic support, need for intubation and hospital stay lasting longer than 7 days RESULTS: The sample size consisted of 99 patients: admission data to calculate a MELD-Na score was available for 63 patients (63%) The MELD-Na score was found to be significantly higher in those who died at 30 days (14 38±6 92) after discharge relative to those who survived (9 68±5 69;P = 0 03);the odds of death at 30 days with a MELD-Na score greater than 10 was 9 00 (95% CI: 2 29, 35 50;P = 0 001) Patients with a MELD-Na score greater than 10 were more likely to have an AKI by an odds ratio (OR) of 3 31 (95% CI: 1 08, 10 17, P = 0 03), need HD by an OR of 9 69 (95% CI: 1 74, 53 96, P = 0 007), need vasopressor support by an OR of 4 55 (95% CI: 1 22, 16 99, P = 0 02) and stay in the hospital longer than 7 days by an OR of 4 17 (95% CI: 1 05, 16 47;P = 0 03) CONCLUSION: The MELD-Na score was found to be higher in patients with Covid-19 who died relative to those who survived at 30 days after discharge A MELD-Na score greater than 10 was prognostic of multiple clinical outcomes, including 30-day all cause mortality, development of an AKI, need for HD, need for vasopressors and longer hospital stay Thus, the MELD-Na score serves as a useful clinical scoring system for prognosis in patients admitted to the hospital with Covid-19 (Table Presented)