Hypokalemia as a sensitive biomarker of disease severity and the requirement for invasive mechanical ventilation requirement in COVID-19 pneumonia: A case series of 306 Mediterranean patients.

Autor:	Moreno-P O; Endocrinology and Nutrition Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain; Clinical Medicine Department, Miguel Hernández University, Elche, Spain. Electronic address: omorenoperez@hotmail.es., Leon-Ramirez JM; Pneumology Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: jmleonr@hotmail.com., Fuertes-Kenneally L; Cardiology Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: laurafuertesken@gmail.com., Perdiguero M; Nephrology Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: perdiguero_mig@yahoo.es., Andres M; Clinical Medicine Department, Miguel Hernández University, Elche, Spain; Rheumatology Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: drmarianoandres@gmail.com., Garcia-Navarro M; Internal Medicine Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: marinterna@gmail.com., Ruiz-Torregrosa P; Pneumology Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: paloma.91ruiz@gmail.com., Boix V; Clinical Medicine Department, Miguel Hernández University, Elche, Spain; Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: boix_vic@gva.es., Gil J; Pneumology Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: joangilcarbonell@gmail.com., Merino E; Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: merino_luc@gva.es.
Jazyk:	angličtina
Zdroj:	International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2020 Nov; Vol. 100, pp. 449-454. Date of Electronic Publication: 2020 Sep 17.
DOI:	10.1016/j.ijid.2020.09.033
Abstrakt:	Objectives: Serum levels of potassium (K + ) appear to be significantly lower in severe cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the clinical significance of this is unknown. The objective was to investigate whether hypokalemia acts as a biomarker of severity in coronavirus disease 2019 (COVID-19) pneumonia and is associated with major clinical outcomes. Methods: A retrospective cohort study of inpatients with COVID-19 pneumonia (March 3 to May 2, 2020) was performed. Patients were categorized according to nadir levels of K + in the first 72 h of admission: hypokalemia (K + ≤3.5 mmol/l) and normokalemia (K + >3.5 mmol/l). The main outcomes were all-cause mortality and the need for invasive mechanical ventilation (IMV); these were analyzed by multiple logistic regression (odds ratio (OR), 95% confidence interval (CI)). Results: Three hundred and six patients were enrolled. Ninety-four patients (30.7%) had hypokalemia and these patients showed significantly higher comorbidity (Charlson comorbidity index ≥3, 30.0% vs 16.3%; p =  0.02) and CURB65 scores (median (interquartile range): 1.5 (0.0-3.0) vs 1.0 (0.0-2.0); p =  0.04), as well as higher levels of some inflammatory parameters at baseline. After adjustment for confounders, hypokalemia was independently associated with requiring IMV during the admission (OR 8.98, 95% CI 2.54-31.74). Mortality was 15.0% (n = 46) and was not influenced by low K + . Hypokalemia was associated with longer hospital and ICU stays. Conclusions: Hypokalemia is prevalent in patients with COVID-19 pneumonia. Hypokalemia is an independent predictor of IMV requirement and seems to be a sensitive biomarker of severe progression of COVID-19. (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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