Hastanede yatan Covid-19 pnömoni hastalarında hipokaleminin klinik sonuçlara etkileri
Year 2021,
, 1650 - 1656, 30.12.2021
Bülent Kaya
,
Saime Paydas
,
Tolga Kuzu
,
Omer Demiroglu
,
Sevinç Püren Yücel Karakaya
,
Mustafa Balal
,
Yeşim Taşova
Abstract
Amaç: Çalışmamızda hastanede yatan Covid-19 pnömonili hastalarda hipokaleminin klinik sonuçlar üzerindeki etkilerini araştırdık.
Gereç ve Yöntem: Tek merkezli retrospektif çalışmada, hastanede yatan covid-19 pnömonili hastaların demografik ve klinik özellikleri ile birlikte hastanenin ilk günündeki laboratuvar sonuçları kaydedildi. Hastaların hastanede yatış süreleri, mekanik ventilasyon dahil yoğun bakım gereksinimi ve sağ kalım süreleri belirlendi.
Bulgular: Çalışmamıza yaş ortalaması 64 ± 14.5 (23-90) olan 111 erkek (% 60) olmak üzere 185 hasta dahil edildi. Hastalar hipokalemik (%16.8) ve normokalemik (%83.2) olarak 2 gruba ayrıldı. Diyabetik hasta sayısı normokalemik grupta daha fazlaydı. Hipokalemik grupta serum total protein ve albümin düzeyleri daha düşük, alkalen fosfataz, gama-glutamil transpeptidaz, total bilirubin, direkt bilirubin, kan pH'sı ve bikarbonat düzeyi daha yüksekti. Çoklu lojistik regresyon analizinde alkaloz hipokalemi riskini 5.73 kat artırdı. Hastanede yatış süresi, yoğun bakım gereksinimi ve hastane mortalitesi hipokalemi ve normokalemi hastalarında benzerdi.
Sonuç: Covid-19 pnömoni hastalarında ilk başvuruda hipokalemi %16.8 gibi oldukça yüksek oranda bulunmuştur. Hipokalemi metabolik alkaloz ile ilişkiliydi ancak hastanede kalış süresi, mekanik ventilasyon dahil yoğun bakım gereksinimi ve hastane mortalitesi ile ilişkili değildi.
Supporting Institution
yok
References
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- Referans 19. Nadim MK, Forni LG, Mehta RL, Connor MJ Jr, Liu KD, Ostermann M, et al. COVID-19-associated acute kidney injury: consensus report of the 25th Acute Disease Quality Initiative (ADQI) Workgroup. Nat Rev Nephrol. 2020;16:747-64. doi: 10.1038/s41581-020-00356-5.
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Effects of hypokalemia on clinical outcomes in hospitalized patients with Covid-19 pneumonia
Year 2021,
, 1650 - 1656, 30.12.2021
Bülent Kaya
,
Saime Paydas
,
Tolga Kuzu
,
Omer Demiroglu
,
Sevinç Püren Yücel Karakaya
,
Mustafa Balal
,
Yeşim Taşova
Abstract
Purpose: We investigated the effects of hypokalemia on clinical outcomes in hospitalized patients with Covid-19 pneumonia.
Materials and Methods: In this single-center retrospective study, we recorded characteristics of hospitalized covid-19 pneumonia patients and laboratory test results on the first hospital day. Duration of hospitalization, requiring intensive care including mechanical ventilation and survival, were determined.
Results: Our study included 185 patients and of them 111 male (60% male) patients with mean age of 64 ± 14.5 (23-90). Patients were grouped as hypokalemic (16.8%) and normokalemic patients (83.2%). The number of diabetic patients was higher in the normokalemic group. Serum total protein and albumin levels were lower in hypokalemic group, while alkaline phosphatase, gamma-glutamyl transpeptidase, total bilirubin, direct bilirubin, blood pH and bicarbonate level were higher. In multiple logistic regression analyses, alkalosis increased risk of hypokalemia 5.73 times. Duration of hospitalization, requirement of intensive care and hospital mortality were similar in hypokalemia and normokalemia patients.
Conclusion: In patients with Covid-19 pneumonia, hypokalemia has been found to be quite common as high as 16.8% at the first presentation. Hypokalemia was related to metabolic alkalosis but unrelated to the duration of hospitalization, requirement of intensive care including mechanical ventilation and hospital mortality.
References
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- Referans 2. Jin Y, Yang H, Ji W, Wu W, Chen S, Zhang W, et al. Virology, epidemiology, pathogenesis, and control of COVID-19. Viruses. 2020;12. doi: 10.3390/v12040372.
- Referans 3. Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and ıs blocked by a clinically proven protease ınhibitor. Cell. 2020;181:271-80 e278. doi: 10.1016/j.cell.2020.02.052.
- Referans 4. Machhi J, Herskovitz J, Senan AM, Dutta D, Nath B, Oleynikov MD, et al. The natural history, pathobiology, and clinical manifestations of SARS-CoV-2 infections. J Neuroimmune Pharmacol. 2020;15:359-86. doi: 10.1007/s11481-020-09944-5.
- Referans 5. Zou X, Chen K, Zou J, Han P, Hao J, Han Z. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Front Med. 2020;14:185-92. doi: 10.1007/s11684-020-0754-0.
- Referans 6. Liu J, Liu S. The management of coronavirus disease 2019 (COVID-19). J Med Virol. 2020;92:1484-90. doi: 10.1002/jmv.25965.
- Referans 7. Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, et al. Baseline characteristics and outcomes of 1591 patients ınfected with SARS-CoV-2 admitted to ICUs of the Lombardy region, Italy. JAMA. 2020;323:1574-81. doi: 10.1001/jama.2020.5394.
- Referans 8. Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA. 2020;323:2052-59. doi: 10.1001/jama.2020.6775.
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- Referans 10. Garg S, Kim L, Whitaker M, O'Halloran A, Cummings C, Holstein R, et al. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019 - COVID-NET, 14 States, March 1-30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:458-64. doi: 10.15585/mmwr.mm6915e3.
- Referans 11. Docherty AB, Harrison EM, Green CA, Hardwick HE, Pius R, Norman L, et al. Features of 20 133 UK patients in hospital with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ. 2020; 369:m1985. doi: 10.1136/bmj.m1985.
- Referans 12. Copaescu A, Smibert O, Gibson A, Phillips EJ, Trubiano JA. The role of IL-6 and other mediators in the cytokine storm associated with SARS-CoV-2 infection. J Allergy Clin Immunol. 2020;146:518-34 e511. doi: 10.1016/j.jaci.2020.07.001.
- Referans 13. Li H, Liu L, Zhang D, Xu J, Dai H, Tang N et al. SARS-CoV-2 and viral sepsis: observations and hypotheses. Lancet. 2020;395:1517-20. doi: 10.1016/S0140-6736(20)30920-X.
- Referans 14. Tezcan ME, Dogan Gokce G, Sen N, Zorlutuna Kaymak N, Ozer RS. Baseline electrolyte abnormalities would be related to poor prognosis in hospitalized coronavirus disease 2019 patients. New Microbes New Infect. 2020;37:100753. doi: 10.1016/j.nmni.2020.100753.
- Referans 15. Moreno PO, Leon-Ramirez JM, Fuertes-Kenneally L, Perdiguero M, Andres M, Garcia-Navarro M, et al. 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. Int J Infect Dis. 2020;100:449-54. doi: 10.1016/j.ijid.2020.09.033.
- Referans 16. Szoke D, Caruso S, Aloisio E, Pasqualetti S, Dolci A, Panteghini M. Serum potassium concentrations in COVID-19. Clin Chim Acta. 2021;512:26-27. doi: 10.1016/j.cca.2020.11.012.
- Referans 17. Alfano G, Ferrari A, Fontana F, Perrone R, Mori G, Ascione E, et al. Hypokalemia in patients with COVID-19. Clin Exp Nephrol. 2021;25:401-09. doi: 10.1007/s10157-020-01996-4.
- Referans 18. Poulsen SB, Fenton RA. K(+) and the renin-angiotensin-aldosterone system: new insights into their role in blood pressure control and hypertension treatment. J Physiol. 2019;597:4451-64. doi: 10.1113/JP276844.
- Referans 19. Nadim MK, Forni LG, Mehta RL, Connor MJ Jr, Liu KD, Ostermann M, et al. COVID-19-associated acute kidney injury: consensus report of the 25th Acute Disease Quality Initiative (ADQI) Workgroup. Nat Rev Nephrol. 2020;16:747-64. doi: 10.1038/s41581-020-00356-5.
- Referans 20. Knochel JP. Diuretic-induced hypokalemia. Am J Med. 1984;77:18-27. doi: 10.1016/s0002-9343(84)80004-2
- Referans 21. Lee Hamm L, Hering-Smith KS, Nakhoul NL. Acid-base and potassium homeostasis. Semin Nephrol. 2013;33:257-64. doi: 10.1016/j.semnephrol.2013.04.006.
- Referans 22. Leulseged TW, Hassen IS, Ayele BT, Tsegay YG, Abebe DS, Edo MG, et al. Laboratory biomarkers of COVID-19 disease severity and outcome: Findings from a developing country. PLoS One. 2021;16:e0246087. doi: 10.1371/journal.pone.0246087.
- Referans 23. Abenavoli L, Gentile I, Maraolo AE, Negro F. SARS-CoV-2 and liver damage: a possible pathogenetic link. Hepatobiliary Surg Nutr. 2020;9:322-24. doi: 10.21037/hbsn-20-437.