Journal Article

Hypokalemia in Patients with COVID-19

Volpi, Sara, Ciusa Giacomo, Puzzolante Cinzia, Tutone Marco, Franceschini, Erica, Faltoni Matteo, Girardis Massimo, Dolci Giovanni, Alfano Gaetano, Fantini Riccardo, Bacca Erica, Pellegrino, Francesco, Biagioni Emanuela, Mori Giacomo, Iannone, Anna, Bedini, Andrea, Borella, Rebecca, Ferrari Annachiara, Rogati Carlotta, Borghi Vanni, Orlando, Gabriella, Guaraldi Giovanni, Andreotti, Alberto, Mattioli, Marco, Perrone Rossella, Santoro Antonella, Milic Jovana, Bondi Filippo, Iadisernia Vittorio, Cossarizza Lucia Serio Andrea, Cuomo Gianluca, Damiano, Francesca, Meschiari Marianna, Fontana, Francesco, De Biasi Sara, Busani Stefano, Tartaro Domenico Lo, Carli Federica, Venturi Giulia, Larné Damiano, Fidanza Lucia, Piccinini Francesca, Leonelli, Marco, Menozzi Marianna, Burastero Giulia, Ascione Elisabetta, Tonelli, Roberto, Paolini Annamaria, Pinti Marcello, Bellinazzi Caterina, Scotti Marzia, Raimondi Alessandro, Facchini, Francesca, Mussini Cristina, Ballestri, Marco, Corradi Luca, Margiotta Gianluca, Yaacoub Dina, Pederzoli Simone, Chierego Giovanni, Gibellini Lara, Magistroni Riccardo, Pulizzi Roberto, Romeo M

2021

Overview

BackgroundPatients with COVID-19 experience multiple clinical conditions that may cause electrolyte imbalances. Hypokalemia is a concerning electrolyte disorder closely associated with severe complications. This study aimed to estimate prevalence, risk factors and outcome of hypokalemia in a cohort of patients with confirmed COVID-19.MethodsA retrospective analysis was conducted on 290 non-ICU admitted patients with COVID-19 at the tertiary teaching hospital of Modena, Italy, from February 16 to April 14, 2020.ResultsHypokalemia was detected in 119 out of 290 patients (41%) during hospitalization. Mean serum potassium was 3.1 ± 0.1 meq/L. The majority of patients (90.7%) patients experienced only a mild decrease in serum potassium level (3–3.4 mEq/L). Hypokalemia was associated with hypocalcemia, which was detected in 50% of subjects. Urine potassium-to-creatinine ratio, measured in a small number of patients (n = 45; 36.1%), revealed an increase of urinary potassium excretion in most cases (95.5%).Risk factors for hypokalemia were female sex (odds ratio (OR) 2.44; 95% CI 1.36–4.37; P 0.003) and diuretic therapy (OR 1.94, 95% CI 1.08–3.48; P 0.027). Hypokalemia, adjusted for sex, age and SOFA score, was not associated with ICU transfer (OR 0.52; 95% CI 0.228–1.212; P = 0.131), in-hospital mortality (OR, 0.47; 95% CI 0.170–1.324; P = 0.154) and composite outcome of ICU transfer or in-hospital mortality (OR 0.48; 95% CI 0.222–1.047; P = 0.065) in our cohort of patients.ConclusionsHypokalemia was a frequent disorder in subjects with COVID-19. Female sex and diuretic therapy were identified as risk factors for low serum potassium levels. Hypokalemia was unrelated to ICU transfer and death in this cohort of patients.

• Publisher: Springer Nature B.V
• Subject: Coronaviruses / COVID-19 / Creatinine / Diuretics / Electrolytes / Hypocalcemia / Hypokalemia / Mortality / Patients / Potassium / Risk factors / Sex ratio