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: | Oscar Moreno-P, Jose-Manuel Leon-Ramirez, Laura Fuertes-Kenneally, Miguel Perdiguero, Mariano Andres, Mar Garcia-Navarro, Paloma Ruiz-Torregrosa, Vicente Boix, Joan Gil, Esperanza Merino, Santos Asensio, Cleofé Fernandez, Alfredo Candela, Mª del Mar García, Rosario Sánchez, Sergio Reus, Paloma Ruiz, Raquel García-Sevila, María-Ángeles Martínez, María-Mar García-Mullor, Mar Blanes, Jaime Guijarro, José Carlos Pascual, Iris Gonzalez, Pedro Sanso, José Manuel Ramos, Jaime Javaloy, Clara Llopis, Olga Coronado, Esther García, Gonzalo Rodríguez, Paola Melgar, Mariano Franco, Félix Lluís, Carmen Zaragoza, Cándido Alcaraz, Ana Carrión, Celia Villodre, Emilio Ruiz de la Cuesta, Cristina Alenda, Francisca Peiró, María Planelles, Laura Greco, Sandra Silvia, Antonio Francia, Iván Verdú, Juan Sales, Ana Palacios, Hortensia Ballester, Antonio García-Valentín, Marta Márquez, Eva Canelo, Andrea Juan, Elena Vives, Andrea Revert, Gonzalo Fuente, Ester Nofuentes, Carolina Mangas, Eva Vera, Alicia Ferradas, Helena López, Cristian Herrera, Beatriz López, Marina Morillas, Vanesa Rodríguez, Mercedes Khartabil, Mario Giménez, Ernesto Tovar, Estela Martínez, Lucia Medina, Sandra Baile, Carlos Salazar, Norma Guerra, Sarai Moliner, Mari-Carmen López-González, Blanca Figueres |
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Rok vydání: | 2020 |
Předmět: |
Male
0301 basic medicine endocrine system diseases medicine.medical_treatment urologic and male genital diseases Severity of Illness Index 0302 clinical medicine Interquartile range 030212 general & internal medicine Aged 80 and over General Medicine Middle Aged Hypokalemia Infectious Diseases Female medicine.symptom Coronavirus Infections COVID19 pneumonia Adult Microbiology (medical) medicine.medical_specialty Pneumonia Viral 030106 microbiology mechanical ventilation Article lcsh:Infectious and parasitic diseases Betacoronavirus 03 medical and health sciences Internal medicine Severity of illness hypokalemia cohort study medicine Humans lcsh:RC109-216 Pandemics Aged Retrospective Studies Mechanical ventilation SARS-CoV-2 business.industry COVID-19 nutritional and metabolic diseases Retrospective cohort study Odds ratio medicine.disease Respiration Artificial mortality Comorbidity Pneumonia business Biomarkers |
Zdroj: | International Journal of Infectious Diseases International Journal of Infectious Diseases, Vol 100, Iss, Pp 449-454 (2020) |
ISSN: | 1201-9712 |
Popis: | Highlights • There is a high prevalence of hypokalemia among patients with COVID-19 pneumonia. • This suggests the presence of a disorder in the renin-angiotensin system activity. • Hypokalemia is associated with requiring invasive mechanical ventilation. • Hypokalemia seems to be a sensitive biomarker of severity-progression of COVID-19. • Serum levels of potassium should be closely monitored in these patients. Objectives Serum levels of potassium (K+) seem significantly lower in severe SARS-CoV-2 infection, with an unknown clinical translation. The objective was to investigate whether hypokalemia acts as a biomarker of severity in COVID-19 pneumonia, and associates with major clinical outcomes. Methods Retrospective cohort study of inpatients with COVID-19 pneumonia (March 3 - May 2, 2020). Patients were categorized according to nadir levels of K + in the first 72 hours of admission: hypokalemia (K+ ≤3.5 mmol/L) and normokalemia (>3.5 mmol/L). Main outcomes were all-cause mortality and need of invasive mechanical ventilation (IMV), analyzed by multiple logistic regression (OR; 95%CI). Results 306 patients were enrolled. Ninety-four patients (30.7%) had hypokalemia, showing at baseline significantly higher comorbidity (Charlson index ≥3, 30.0% vs. 16.3%)(p = 0.02), CURB65 scores (1.5(0.0-3.0) vs. 1.0(0.0-2.0))(p = 0.04), and some inflammatory parameters. 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 stay. 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. |
Databáze: | OpenAIRE |
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