Electrolyte Imbalance Among Bangladeshi Patients With COVID-19

Abstract

Introduction Infection with SARS-CoV-2 begins in the lower respiratory tract, but COVID-19 often involves the renal system, resulting in serum electrolyte imbalance. Monitoring serum electrolyte levels and parameters of liver and kidney function is essential to understand disease prognosis. Objectives This study aimed to determine the effect of imbalances in serum electrolytes and other parameters on COVID-19 severity. Material and method This retrospective study comprised 241 patients, ages 14 years and older, including 186 patients who were moderately affected and 55 who were categorized as severely affected by COVID-19. Serum electrolytes (sodium (Na + ), potassium (K + ), and chloride (Cl − )) and biomarkers of kidney and liver function (creatinine and alanine aminotransferase (ALT)) were measured and correlated with disease severity. This research was conducted among admitted patients of Holy Family Red Crescent Medical College Hospital designated into two groups based on retrospective hospital records. Individuals with moderate illness had evidence of lower respiratory tract infection (cough, cold, breathless, etc.) during clinical assessment or imaging (chest X-ray and computed tomography (CT) scan of the lungs) and have an oxygen saturation by pulse oximetry (SpO 2 ) ≥ 94% on room air at sea level. The severely ill group involved individuals with SpO 2 ≤94% on room air at sea level and respiratory rate ≥ 30 breaths/minute, and critically ill patients are those who needed mechanical ventilation or required intensive care unit (ICU) care. This categorization was based on the Coronavirus Disease 2019 (COVID-19) Treatment Guidelines ( https://www.covid19treatmentguidelines.nih.gov/about-the-guidelines/whats-new /). Results Average Na + and creatinine increased by 2.30 parts (95% confidence interval (CI) = 0.20, 4.81, P = 0.041) and 0.35 units (95% CI = 0.03, 0.68, P = 0.043) in severe cases compared with moderate cases. Older participants had relatively Na + lowered to -0.06 parts (95% CI = -0.12, -0.001, P = 0.045), significant Cl − reduction by 0.09 units (95% CI = -0.14, -0.04, P = 0.001), and ALT by 0.47 units (95% CI = -0.88, -0.06, P = 0.024), whereas serum creatinine was increased by 0.01 parts (95% CI = 0.001, 0.02, P = 0.024). The creatinine and ALT of COVID-19 participants were significantly higher in males by 0.34 units and 23.2 units, respectively, compared with females. In severe COVID-19 cases compared with moderate cases, the risks of hypernatremia, elevated chloride levels, and elevated serum creatinine levels were increased by 2.83-fold (95% CI = 1.26, 6.36, P = 0.012), 5.37-fold (95% CI = 1.90, 15.3, P = 0.002), and 2.00-fold (95% CI = 1.08, 4.31, P = 0.039), respectively. Conclusion S...

Biochemical Role of Blood Electrolytes in Old Iraqi Patients with COVID-19

“…Regarding Table 3 , various studies agreed with the present outcomes , these studies proposed that hypochloremia (lower levels of chloride electrolyte ) is a remarkably common electrolytes disorders in COVID-19 patients (7,(17)(18)(19). When chloride balance is disrupted , it can trigger the acute nephritic injury (7,18). On the other hand, metabolic acidosis in COVID-19 patients due to lactic acid higher production is reflected by higher activity of lactate dehydrogenase which responsible for conversion of pyruvate to lactate, (20) as reported in table 4.…”

“…The present study submits reasonable mechanisms for hyponatremia and hyperkalemia in old COVID-19 patients on the basis of both the disease complications and the aging manifestations . Regarding Table 3 , various studies agreed with the present outcomes , these studies proposed that hypochloremia (lower levels of chloride electrolyte ) is a remarkably common electrolytes disorders in COVID-19 patients (7,(17)(18)(19). When chloride balance is disrupted , it can trigger the acute nephritic injury (7,18).…”

Electrolyte disturbances in patients hospitalized for COVID-19 infection: An observational study

“…[4,5] The electrolyte imbalances in patients suffering from COVID-19 may be caused by AKI or gastrointestinal (GI) losses. [6] It is important to remember the pathophysiology while discussing disease outcomes, as a multifactorial etiology may confound the interpretation of some results. Some studies suggest that electrolyte concentrations can serve as reliable indicators of the condition and prognosis of COVID-19 patients.…”

“…Some studies suggest that electrolyte concentrations can serve as reliable indicators of the condition and prognosis of COVID-19 patients. [6][7][8] Similarly, hyponatremia, often due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH), has been linked to a higher mortality risk in patients with bacterial pneumonia, although the pathophysiologic mechanisms of SIADH development in those patients remain incompletely understood. [9][10][11] In many other conditions, electrolyte derangements signify more advanced or severe disease.…”