Effect of Electrolyte Imbalance on Mortality and Late Acute Kidney Injury in Hospitalized COVID-19 Patients

Authors

  • Tahereh Sabaghian Clinical Research Development Center, Imam Hossein Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Mohamadjavad Honarvar Clinical Research Development Center, Imam Hossein Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Seyed Amir Ahmad Safavi-Naini National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Arefe Sadat Sadeghi Fadaki Clinical Research Development Center, Imam Hossein Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Mohamad Amin Pourhoseingholi Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Hamidreza Hatamabadi Safety Promotion and Injury Prevention Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran

Abstract

Introduction. As a multisystem illness, Coronavirus disease 2019 (COVID-19) can damage different organs. This study investigated the effect of electrolyte imbalance (EI), with or without concomitant renal dysfunction, on the prognosis of COVID-19 in hospitalized patients. Methods. We evaluated 499 hospitalized patients with confirmed COVID-19, without a history of chronic kidney disease. The patients’ demographic data, laboratory values, and outcomes were retrospectively collected from the hospital information system. Serumelectrolytes including sodium, potassium, magnesium, calcium, and phosphorus abnormalities were analyzed on admission and during the hospitalization period. The outcomes of this study were the occurrence of acute kidney injury (AKI) after the first week of hospitalization and in-hospital mortality rate. Multivariate analyses were carried out to obtain the independent risk of each EI on mortality, by adjusting for age, gender, and AKI occurrence. Results. Among the 499 COVID-19 patients (60.9% male), AKI occurred in 168 (33.7%) and mortality in 92 (18.4%) cases. Hypocalcemia (38%) and hyponatremia (22.6%) were the most prevalent EIs, and all EIs were more common in the AKI group than in the non-AKI group. Hyponatremia (Adjusted Odds ratio [AOR] = 2.34, 95% CI: 1.30 to 4.18), hypernatremia (AOR = 8.52, 95% CI: 1.95 to 37.32), and hyperkalemia (AOR = 4.63, 95% CI: 1.65 to 13) on admission were associated with poor prognosis. Moreover, hyponatremia (AOR = 3.02, 95% CI: 1.28 to 7.15) and hyperphosphatemia (AOR = 5.12, 95% CI: 1.24 to 21.09) on admission were associated with late AKI occurrence. Conclusion. This study highlights the role of hyponatremia, hypernatremia, hyperkalemia, and hyperphosphatemia in poor prognosis of COVID-19. According to the independent effect of EI on late AKI and mortality, we recommend physicians to raise awareness to closely monitor and correct EI during hospitalization.

 

DOI: 10.52547/ijkd.6904

Author Biographies

  • Tahereh Sabaghian, Clinical Research Development Center, Imam Hossein Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
    Faculty of Nephrology
  • Mohamadjavad Honarvar, Clinical Research Development Center, Imam Hossein Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
    Medical student
  • Seyed Amir Ahmad Safavi-Naini, National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran
    Medical Doctorate
  • Arefe Sadat Sadeghi Fadaki, Clinical Research Development Center, Imam Hossein Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
    Resident of Internal Medicine
  • Mohamad Amin Pourhoseingholi, Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
    Faculty of Biostatistics
  • Hamidreza Hatamabadi, Safety Promotion and Injury Prevention Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran
    Faculty of Emergency Medicine

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Published

2022-08-12

Issue

Section

ORIGINAL | Kidney Diseases