Electrolytes Disturbance in Hospitalized Patients with COVID-19 and Related Outcomes

Export Objective: Global morbidity and death due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic are at an all-time high. Renal involvement in a variety of forms, such as serum electrolyte abnormalities, is widespread and comes with a confusing array of problems. To study the presence of electrolyte disturbances in severe COVID-19, we investigated the prevalence and consequences of changes in electrolytes over time. Methods: This prospective study involved one hundred patients with severe COVID-19 infection. Serum electrolytes were recorded at admission, five, and ten days after admission. Two groups were defined in this study according to the patients’ level of sodium at admission: hyponatremia group (serum Na+<135 mmol/L, N=34 patients) and normonatremia group (serum Na+ 135-145 mmol/L, N=62 patients). Results: The mean age of the cases was 62.5±15.5 years. It was found that on admission 34% of cases had hyponatremia, 7% had hyperkalemia, 58% had hypocalcemia, and 16% had hyperchloremia. Regarding complications and outcomes of severe COVID-19 patients in our study, the most common complication was respiratory failure (25%) followed by acute kidney injury (15%) and new-onset diabetes (10%). At any point in time, hyperkalemia and hyperchloremia was associated with higher risk of death (HR=3.29, P-value=0.006 for potassium and HR=2.78, P-value=0.02 for chloride). Comparing the trend for survival in the hyponatremia and normonatremia groups, no difference between them was found (log-rank test, P-value=0.22). Conclusions: COVID-19 hospitalized patients commonly exhibited electrolyte imbalances at admission, with hypocalcemia (58%), hyponatremia (34%), and hyperchloremia (16%) being prominent. Monitoring and addressing these aberrations are crucial for comprehensive patient management.