Is low level of serum phosphorus within normal range a predictive parameter for disease severity in hospitalized COVID-19 patients?

Abstract

Background: Patients with COVID-19 may develop several electrolyte imbalances that can cause multiple clinical complications. Muscle ATP synthesis decrease due to low serum phosphorous levels may also cause respiratory muscle weakness. We investigated the predictive power of serum phosphorus levels in patients with hospitalized COVID-19. Material and Methods: Our retrospective and observational study was carried out for 957 patients who suffered from SARS-CoV-2 diagnosed by real-time PCR testing and hospitalized due to moderate or severe pneumonia due to COVID-19. Results: Among 957 patients with COVID-19 pneumonia, 387 (40,4%) were moderate and 570 (59,6%) were severe. Although they were within the reference range, the phosphorus levels were significantly lower in severe patients. Our final analysis showed that age, respiratory rate, d-dimer, and phosphorus level were independent risk factors for disease severity. Phosphorus level was found to have a negative correlation with respiratory rate (r: 0,091, p=0,005) and positive with SPO2 (r: 0,069, p=0,03). Conclusion: Our results suggest that phosphorus level has a prognostic significance due to its correlation with the respiratory rate and must be considered to be an independent risk factor for the patient status, especially in severe cases. It is concluded that phosphorus monitoring, at least in severe patients, may prevent serious clinical consequences such as respiratory insufficiency.

Keywords

• COVID-19 pneumonia
• phosphorus
• respiratory muscle
• disease status

Is low level of serum phosphorus within normal range a predictive parameter for disease severity in hospitalized COVID-19 patients?

Abstract

Background: Patients with COVID-19 may develop several electrolyte imbalances that can cause multiple clinical complications. Low serum phosphorous level usually leads to a decreased muscle ATP synthesis which may cause diaphragmatic or other kinds of respiratory muscle weakness. We investigated the predictive power of serum phosphorus levels in patients with hospitalized COVID-19. Material and Methods: This is a retrospective and observational study of 957 patients with SARS-CoV-2, who were diagnosed with COVID-19 by real-time PCR testing and hospitalized due to moderate and severe COVID-19 pneumonia. Results: Among 957 patients with COVID-19 pneumonia, 387 (40,4%) were moderate and 570 (59,6%) were severe. Phosphorus was significantly lower in severe patients, within the reference range. Our final analysis showed that age, respiratory rate, d-dimer, and phosphorus level were independent risk factors for disease severity. Phosphorus was found to be negative correlated with respiratory rate (r: 0,091, p=0,005) and was positive correlated with SPO2 (r: 0,069, p=0,03). Conclusion: Our results suggest prognostic significance of phosphorus level, which has correlation with the respiratory rate and has considered to be independent risk factor for disease status, especially in severe patients. It is concluded that phosphorus monitoring, at least in severe patients, may prevent serious clinical consequences such as respiratory insufficiency. Keyword; COVID-19, pneumonia, phosphorus, respiratory muscle, disease status, predictive value

Keywords

• COVID-19
• pneumonia
• phosphorus
• respiratory muscle
• disease status
• predictive value

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