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
Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved..
OBJECTIVES: Serum levels of potassium (K+) appear to be significantly lower in severe cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the clinical significance of this is unknown. The objective was to investigate whether hypokalemia acts as a biomarker of severity in coronavirus disease 2019 (COVID-19) pneumonia and is associated with major clinical outcomes.
METHODS: A retrospective cohort study of inpatients with COVID-19 pneumonia (March 3 to May 2, 2020) was performed. Patients were categorized according to nadir levels of K+ in the first 72 h of admission: hypokalemia (K+ ≤3.5 mmol/l) and normokalemia (K+ >3.5 mmol/l). The main outcomes were all-cause mortality and the need for invasive mechanical ventilation (IMV); these were analyzed by multiple logistic regression (odds ratio (OR), 95% confidence interval (CI)).
RESULTS: Three hundred and six patients were enrolled. Ninety-four patients (30.7%) had hypokalemia and these patients showed significantly higher comorbidity (Charlson comorbidity index ≥3, 30.0% vs 16.3%; p = 0.02) and CURB65 scores (median (interquartile range): 1.5 (0.0-3.0) vs 1.0 (0.0-2.0); p = 0.04), as well as higher levels of some inflammatory parameters at baseline. After adjustment for confounders, hypokalemia was independently associated with requiring IMV during the admission (OR 8.98, 95% CI 2.54-31.74). Mortality was 15.0% (n = 46) and was not influenced by low K+. Hypokalemia was associated with longer hospital and ICU stays.
CONCLUSIONS: Hypokalemia is prevalent in patients with COVID-19 pneumonia. Hypokalemia is an independent predictor of IMV requirement and seems to be a sensitive biomarker of severe progression of COVID-19.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:100 |
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| Enthalten in: |
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases - 100(2020) vom: 17. Nov., Seite 449-454 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Moreno-P, Oscar [VerfasserIn] |
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| Links: |
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| Themen: |
Biomarkers |
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| Anmerkungen: |
Date Completed 01.12.2020 Date Revised 10.06.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ijid.2020.09.033 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM315221046 |
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| 100 | 1 | |a Moreno-P, Oscar |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Hypokalemia as a sensitive biomarker of disease severity and the requirement for invasive mechanical ventilation requirement in COVID-19 pneumonia |b A case series of 306 Mediterranean patients |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Completed 01.12.2020 | ||
| 500 | |a Date Revised 10.06.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a OBJECTIVES: Serum levels of potassium (K+) appear to be significantly lower in severe cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the clinical significance of this is unknown. The objective was to investigate whether hypokalemia acts as a biomarker of severity in coronavirus disease 2019 (COVID-19) pneumonia and is associated with major clinical outcomes | ||
| 520 | |a METHODS: A retrospective cohort study of inpatients with COVID-19 pneumonia (March 3 to May 2, 2020) was performed. Patients were categorized according to nadir levels of K+ in the first 72 h of admission: hypokalemia (K+ ≤3.5 mmol/l) and normokalemia (K+ >3.5 mmol/l). The main outcomes were all-cause mortality and the need for invasive mechanical ventilation (IMV); these were analyzed by multiple logistic regression (odds ratio (OR), 95% confidence interval (CI)) | ||
| 520 | |a RESULTS: Three hundred and six patients were enrolled. Ninety-four patients (30.7%) had hypokalemia and these patients showed significantly higher comorbidity (Charlson comorbidity index ≥3, 30.0% vs 16.3%; p = 0.02) and CURB65 scores (median (interquartile range): 1.5 (0.0-3.0) vs 1.0 (0.0-2.0); p = 0.04), as well as higher levels of some inflammatory parameters at baseline. After adjustment for confounders, hypokalemia was independently associated with requiring IMV during the admission (OR 8.98, 95% CI 2.54-31.74). Mortality was 15.0% (n = 46) and was not influenced by low K+. Hypokalemia was associated with longer hospital and ICU stays | ||
| 520 | |a CONCLUSIONS: Hypokalemia is prevalent in patients with COVID-19 pneumonia. Hypokalemia is an independent predictor of IMV requirement and seems to be a sensitive biomarker of severe progression of COVID-19 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID19 pneumonia | |
| 650 | 4 | |a Cohort study | |
| 650 | 4 | |a Hypokalemia | |
| 650 | 4 | |a Mechanical ventilation | |
| 650 | 4 | |a Mortality | |
| 650 | 7 | |a Biomarkers |2 NLM | |
| 700 | 1 | |a Leon-Ramirez, Jose-Manuel |e verfasserin |4 aut | |
| 700 | 1 | |a Fuertes-Kenneally, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Perdiguero, Miguel |e verfasserin |4 aut | |
| 700 | 1 | |a Andres, Mariano |e verfasserin |4 aut | |
| 700 | 1 | |a Garcia-Navarro, Mar |e verfasserin |4 aut | |
| 700 | 1 | |a Ruiz-Torregrosa, Paloma |e verfasserin |4 aut | |
| 700 | 1 | |a Boix, Vicente |e verfasserin |4 aut | |
| 700 | 1 | |a Gil, Joan |e verfasserin |4 aut | |
| 700 | 1 | |a Merino, Esperanza |e verfasserin |4 aut | |
| 700 | 0 | |a COVID19-ALC Research Group |e verfasserin |4 aut | |
| 700 | 1 | |a Asensio, Santos |e investigator |4 oth | |
| 700 | 1 | |a Fernandez, Cleofé |e investigator |4 oth | |
| 700 | 1 | |a Candela, Alfredo |e investigator |4 oth | |
| 700 | 1 | |a Del Mar García, Mª |e investigator |4 oth | |
| 700 | 1 | |a Sánchez, Rosario |e investigator |4 oth | |
| 700 | 1 | |a Reus, Sergio |e investigator |4 oth | |
| 700 | 1 | |a Ruiz, Paloma |e investigator |4 oth | |
| 700 | 1 | |a García-Sevila, Raquel |e investigator |4 oth | |
| 700 | 1 | |a Martínez, María-Ángeles |e investigator |4 oth | |
| 700 | 1 | |a García-Mullor, María-Mar |e investigator |4 oth | |
| 700 | 1 | |a Blanes, Mar |e investigator |4 oth | |
| 700 | 1 | |a Guijarro, Jaime |e investigator |4 oth | |
| 700 | 1 | |a Pascual, José Carlos |e investigator |4 oth | |
| 700 | 1 | |a Gonzalez, Iris |e investigator |4 oth | |
| 700 | 1 | |a Sanso, Pedro |e investigator |4 oth | |
| 700 | 1 | |a Ramos, José Manuel |e investigator |4 oth | |
| 700 | 1 | |a Javaloy, Jaime |e investigator |4 oth | |
| 700 | 1 | |a Llopis, Clara |e investigator |4 oth | |
| 700 | 1 | |a Coronado, Olga |e investigator |4 oth | |
| 700 | 1 | |a García, Esther |e investigator |4 oth | |
| 700 | 1 | |a Rodríguez, Gonzalo |e investigator |4 oth | |
| 700 | 1 | |a Melgar, Paola |e investigator |4 oth | |
| 700 | 1 | |a Franco, Mariano |e investigator |4 oth | |
| 700 | 1 | |a Lluís, Félix |e investigator |4 oth | |
| 700 | 1 | |a Zaragoza, Carmen |e investigator |4 oth | |
| 700 | 1 | |a Alcaraz, Cándido |e investigator |4 oth | |
| 700 | 1 | |a Carrión, Ana |e investigator |4 oth | |
| 700 | 1 | |a Villodre, Celia |e investigator |4 oth | |
| 700 | 1 | |a de la Cuesta, Emilio Ruiz |e investigator |4 oth | |
| 700 | 1 | |a Alenda, Cristina |e investigator |4 oth | |
| 700 | 1 | |a Peiró, Francisca |e investigator |4 oth | |
| 700 | 1 | |a Planelles, María |e investigator |4 oth | |
| 700 | 1 | |a Greco, Laura |e investigator |4 oth | |
| 700 | 1 | |a Silvia, Sandra |e investigator |4 oth | |
| 700 | 1 | |a Francia, Antonio |e investigator |4 oth | |
| 700 | 1 | |a Verdú, Iván |e investigator |4 oth | |
| 700 | 1 | |a Sales, Juan |e investigator |4 oth | |
| 700 | 1 | |a Palacios, Ana |e investigator |4 oth | |
| 700 | 1 | |a Ballester, Hortensia |e investigator |4 oth | |
| 700 | 1 | |a García-Valentín, Antonio |e investigator |4 oth | |
| 700 | 1 | |a Márquez, Marta |e investigator |4 oth | |
| 700 | 1 | |a Canelo, Eva |e investigator |4 oth | |
| 700 | 1 | |a Juan, Andrea |e investigator |4 oth | |
| 700 | 1 | |a Vives, Elena |e investigator |4 oth | |
| 700 | 1 | |a Revert, Andrea |e investigator |4 oth | |
| 700 | 1 | |a Fuente, Gonzalo |e investigator |4 oth | |
| 700 | 1 | |a Nofuentes, Ester |e investigator |4 oth | |
| 700 | 1 | |a Mangas, Carolina |e investigator |4 oth | |
| 700 | 1 | |a Vera, Eva |e investigator |4 oth | |
| 700 | 1 | |a Ferradas, Alicia |e investigator |4 oth | |
| 700 | 1 | |a López, Helena |e investigator |4 oth | |
| 700 | 1 | |a Herrera, Cristian |e investigator |4 oth | |
| 700 | 1 | |a López, Beatriz |e investigator |4 oth | |
| 700 | 1 | |a Morillas, Marina |e investigator |4 oth | |
| 700 | 1 | |a Rodríguez, Vanesa |e investigator |4 oth | |
| 700 | 1 | |a Khartabil, Mercedes |e investigator |4 oth | |
| 700 | 1 | |a Giménez, Mario |e investigator |4 oth | |
| 700 | 1 | |a Tovar, Ernesto |e investigator |4 oth | |
| 700 | 1 | |a Martínez, Estela |e investigator |4 oth | |
| 700 | 1 | |a Medina, Lucia |e investigator |4 oth | |
| 700 | 1 | |a Baile, Sandra |e investigator |4 oth | |
| 700 | 1 | |a Salazar, Carlos |e investigator |4 oth | |
| 700 | 1 | |a Guerra, Norma |e investigator |4 oth | |
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| 700 | 1 | |a López-González, Mari-Carmen |e investigator |4 oth | |
| 700 | 1 | |a Figueres, Blanca |e investigator |4 oth | |
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