Correlation between hypophosphatemia and the severity of Corona Virus Disease 2019 patients

Xiaobo Xue; Jing Ma; Yuxia Zhao; Aibin Zhao; Xiaohong Liu; Wei Guo; Fang Yan; Zhixin Wang; Yanqing Guo; Mengbai Fan

Some studies have found that the incidence of hypophosphatemia in critically ill patients can be as high as 44.8% 9 . In our study, serum phosphorus levels were lower than normal in 50% of the severe/critical patients, and the level of serum phosphorus in severe / critical patients was lower than that in normal patients. This may be due to the decrease of the level of glycerol 2,3-diphosphate in erythrocytes under the condition of hypophosphatemia, which leads to the left shift of the oxygen dissociation curve, the decrease of oxygen release and the disorder of oxidative phosphorylation process, and finally leads to tissue hypoxia due to the decrease of ATP energy supply 10 . At the same time, the disturbance of lung water absorption is closely related to the metabolic disorder of phosphorus, the lack of phosphorus aggravates the inflammatory level of lung tissue, the ratio of ventilation and blood flow of edematous lung tissue is maladjusted, and the oxygenation function decreases, which can induce fatigue caused by hypoxia in intercostal muscle and diaphragm. At the same time, the production of pulmonary surfactant is reduced, pulmonary alveoli are trapped, and respiratory failure is further aggravated 11 . Some studies have confirmed that timely correction of hypophosphatemia in patients with hypophosphatemia can reverse the above symptoms and improve the prognosis [12] [13] .