tetano
Editor, Senior Moderator
Clin Exp Nephrol
. 2021 Jan 4.
doi: 10.1007/s10157-020-01996-4. Online ahead of print.
Hypokalemia in Patients with COVID-19
Gaetano Alfano[SUP] 1 2 3 [/SUP], Annachiara Ferrari[SUP] 4 [/SUP], Francesco Fontana[SUP] 5 [/SUP], Rossella Perrone[SUP] 4 [/SUP], Giacomo Mori[SUP] 5 [/SUP], Elisabetta Ascione[SUP] 5 [/SUP], Riccardo Magistroni[SUP] 4 5 [/SUP], Giulia Venturi[SUP] 6 [/SUP], Simone Pederzoli[SUP] 7 [/SUP], Gianluca Margiotta[SUP] 7 [/SUP], Marilina Romeo[SUP] 7 [/SUP], Francesca Piccinini[SUP] 7 [/SUP], Giacomo Franceschi[SUP] 8 [/SUP], Sara Volpi[SUP] 8 [/SUP], Matteo Faltoni[SUP] 8 [/SUP], Giacomo Ciusa[SUP] 8 [/SUP], Erica Bacca[SUP] 8 [/SUP], Marco Tutone[SUP] 8 [/SUP], Alessandro Raimondi[SUP] 8 [/SUP], Marianna Menozzi[SUP] 8 [/SUP], Erica Franceschini[SUP] 8 [/SUP], Gianluca Cuomo[SUP] 8 [/SUP], Gabriella Orlando[SUP] 8 [/SUP], Antonella Santoro[SUP] 8 [/SUP], Margherita Di Gaetano[SUP] 8 [/SUP], Cinzia Puzzolante[SUP] 8 [/SUP], Federica Carli[SUP] 8 [/SUP], Andrea Bedini[SUP] 8 [/SUP], Jovana Milic[SUP] 9 8 [/SUP], Marianna Meschiari[SUP] 8 [/SUP], Cristina Mussini[SUP] 8 [/SUP], Gianni Cappelli[SUP] 4 5 [/SUP], Giovanni Guaraldi[SUP] 8 [/SUP], Modena Covid-19 Working Group (MoCo19)
Collaborators, Affiliations
Abstract
Background: Patients with COVID-19 experience multiple clinical conditions that may cause electrolyte imbalances. Hypokalemia is a concerning electrolyte disorder closely associated with severe complications. This study aimed to estimate prevalence, risk factors and outcome of hypokalemia in a cohort of patients with confirmed COVID-19.
Methods: A retrospective analysis was conducted on 290 non-ICU admitted patients with COVID-19 at the tertiary teaching hospital of Modena, Italy, from February 16 to April 14, 2020.
Results: Hypokalemia was detected in 119 out of 290 patients (41%) during hospitalization. Mean serum potassium was 3.1 ? 0.1 meq/L. The majority of patients (90.7%) patients experienced only a mild decrease in serum potassium level (3-3.4 mEq/L). Hypokalemia was associated with hypocalcemia, which was detected in 50% of subjects. Urine potassium-to-creatinine ratio, measured in a small number of patients (n = 45; 36.1%), revealed an increase of urinary potassium excretion in most cases (95.5%). Risk factors for hypokalemia were female sex (odds ratio (OR) 2.44; 95% CI 1.36-4.37; P 0.003) and diuretic therapy (OR 1.94, 95% CI 1.08-3.48; P 0.027). Hypokalemia, adjusted for sex, age and SOFA score, was not associated with ICU transfer (OR 0.52; 95% CI 0.228-1.212; P = 0.131), in-hospital mortality (OR, 0.47; 95% CI 0.170-1.324; P = 0.154) and composite outcome of ICU transfer or in-hospital mortality (OR 0.48; 95% CI 0.222-1.047; P = 0.065) in our cohort of patients.
Conclusions: Hypokalemia was a frequent disorder in subjects with COVID-19. Female sex and diuretic therapy were identified as risk factors for low serum potassium levels. Hypokalemia was unrelated to ICU transfer and death in this cohort of patients.
Keywords: COVID; Coronavirus; Electrolytes; Hypokalemia; Magnesium; Potassium.
. 2021 Jan 4.
doi: 10.1007/s10157-020-01996-4. Online ahead of print.
Hypokalemia in Patients with COVID-19
Gaetano Alfano[SUP] 1 2 3 [/SUP], Annachiara Ferrari[SUP] 4 [/SUP], Francesco Fontana[SUP] 5 [/SUP], Rossella Perrone[SUP] 4 [/SUP], Giacomo Mori[SUP] 5 [/SUP], Elisabetta Ascione[SUP] 5 [/SUP], Riccardo Magistroni[SUP] 4 5 [/SUP], Giulia Venturi[SUP] 6 [/SUP], Simone Pederzoli[SUP] 7 [/SUP], Gianluca Margiotta[SUP] 7 [/SUP], Marilina Romeo[SUP] 7 [/SUP], Francesca Piccinini[SUP] 7 [/SUP], Giacomo Franceschi[SUP] 8 [/SUP], Sara Volpi[SUP] 8 [/SUP], Matteo Faltoni[SUP] 8 [/SUP], Giacomo Ciusa[SUP] 8 [/SUP], Erica Bacca[SUP] 8 [/SUP], Marco Tutone[SUP] 8 [/SUP], Alessandro Raimondi[SUP] 8 [/SUP], Marianna Menozzi[SUP] 8 [/SUP], Erica Franceschini[SUP] 8 [/SUP], Gianluca Cuomo[SUP] 8 [/SUP], Gabriella Orlando[SUP] 8 [/SUP], Antonella Santoro[SUP] 8 [/SUP], Margherita Di Gaetano[SUP] 8 [/SUP], Cinzia Puzzolante[SUP] 8 [/SUP], Federica Carli[SUP] 8 [/SUP], Andrea Bedini[SUP] 8 [/SUP], Jovana Milic[SUP] 9 8 [/SUP], Marianna Meschiari[SUP] 8 [/SUP], Cristina Mussini[SUP] 8 [/SUP], Gianni Cappelli[SUP] 4 5 [/SUP], Giovanni Guaraldi[SUP] 8 [/SUP], Modena Covid-19 Working Group (MoCo19)
Collaborators, Affiliations
- PMID: 33398605
- DOI: 10.1007/s10157-020-01996-4
Abstract
Background: Patients with COVID-19 experience multiple clinical conditions that may cause electrolyte imbalances. Hypokalemia is a concerning electrolyte disorder closely associated with severe complications. This study aimed to estimate prevalence, risk factors and outcome of hypokalemia in a cohort of patients with confirmed COVID-19.
Methods: A retrospective analysis was conducted on 290 non-ICU admitted patients with COVID-19 at the tertiary teaching hospital of Modena, Italy, from February 16 to April 14, 2020.
Results: Hypokalemia was detected in 119 out of 290 patients (41%) during hospitalization. Mean serum potassium was 3.1 ? 0.1 meq/L. The majority of patients (90.7%) patients experienced only a mild decrease in serum potassium level (3-3.4 mEq/L). Hypokalemia was associated with hypocalcemia, which was detected in 50% of subjects. Urine potassium-to-creatinine ratio, measured in a small number of patients (n = 45; 36.1%), revealed an increase of urinary potassium excretion in most cases (95.5%). Risk factors for hypokalemia were female sex (odds ratio (OR) 2.44; 95% CI 1.36-4.37; P 0.003) and diuretic therapy (OR 1.94, 95% CI 1.08-3.48; P 0.027). Hypokalemia, adjusted for sex, age and SOFA score, was not associated with ICU transfer (OR 0.52; 95% CI 0.228-1.212; P = 0.131), in-hospital mortality (OR, 0.47; 95% CI 0.170-1.324; P = 0.154) and composite outcome of ICU transfer or in-hospital mortality (OR 0.48; 95% CI 0.222-1.047; P = 0.065) in our cohort of patients.
Conclusions: Hypokalemia was a frequent disorder in subjects with COVID-19. Female sex and diuretic therapy were identified as risk factors for low serum potassium levels. Hypokalemia was unrelated to ICU transfer and death in this cohort of patients.
Keywords: COVID; Coronavirus; Electrolytes; Hypokalemia; Magnesium; Potassium.