Baseline electrolyte abnormalities would be related to poor prognosis in hospitalized COVID-19 patients

Tezcan, Mehmet Engin; Dogan gokce, Gizem; Sen, Nesrin; Zorlutuna kaymak, Nilufer; Ozer, Rasit Serdar

Background Electrolyte abnormalities are not uncommon in Corona virus disease 2019 (COVID-19). The data of several studies suggest that various electrolyte imbalances seem to be having impact on disease prognosis. However, no study in literature primarily focused on baseline electrolyte abnormalities’ effect on disease outcome. In this study, we assessed the validity of the hypothesis: “The baseline electrolyte imbalances may be related to unfavourable outcomes in the hospitalized COVID-19 patients”. Material-Methods Design of the study was retrospective and observational. We included 408 hospitalized COVID-19 patients over 18 years old. Baseline levels of sodium, potassium, calcium and chloride were assessed. We evaluated the effect of those electrolytes’ abnormalities on intensive care unit and mechanical ventilation requirement, hospitalization duration and treatment outcome. Also, we clustered the patients based upon electrolyte levels. Thereafter, we compared the clusters according to outcome variables and then, we compared the frequency of other severe disease indices between the clusters. Lastly, we evaluated the independent factors related to COVID -19 associated deaths with multivariate analyse. Results 228 (55.8%) of the patients had at least one electrolyte imbalances at baseline. Hyponatremia was the most frequent electrolyte abnormality. Patients with hyponatremia, hypochloride or hypocalcemia respectively would have more frequent requirement of intensive care unit and mechanical ventilation; higher mortality rate and longer hospitalization. Moreover, the cluster associated with electrolyte abnormalities had unfavourable outcome. Also, clinical and laboratory features associated with severe disease were detected more often in those cluster. Furthermore, hyponatremia was found as one of the independent factors related to death from COVID-19 (OR 10.33; CI %95 1.62-65.62; p=0.01) Conclusion Baseline electrolyte imbalances, primarily hyponatremia would be related to poor prognosis in COVID-19 and baseline electrolyte assessment would be beneficial for evaluating the risk of severe COVID-19.