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高镁血症和高磷血症在 COVID-19 患者中非常普遍,并且增加了死亡风险。

Hypermagnesemia and hyperphosphatemia are highly prevalent in patients with COVID-19 and increase the risk of death.

机构信息

Department of Laboratory Medicine, Medical University of Warsaw, Warsaw, Poland; Doctoral School at Medical University of Warsaw, Warsaw, Poland.

Department of Laboratory Medicine, Medical University of Warsaw, Warsaw, Poland; Central Laboratory, Central Teaching Hospital of University Clinical Center of Medical University of Warsaw, Warsaw, Poland.

出版信息

Int J Infect Dis. 2022 Sep;122:543-549. doi: 10.1016/j.ijid.2022.06.057. Epub 2022 Jul 5.

Abstract

OBJECTIVES

Nonrespiratory manifestations of COVID-19 include endocrine disorders, among which are calcium-magnesium-phosphate homeostasis abnormalities, which seem to influence the disease severity and patient outcome. The aim of this study was to evaluate the prevalence and impact of calcium-magnesium-phosphate and vitamin D3 disorders on survival in patients hospitalized for COVID-19 depending on the severity of the disease and kidney function.

DESIGN OR METHODS

The study was conducted between April 2020 and May 2021 at Central Clinical Hospital in Warsaw, Poland. A total of 146 patients who had tested concentration of at least one of the studied elements, estimated glomerular filtration ratio, creatinine levels, and blood saturation, and were diagnosed with COVID-19 disease were included in the analysis.

RESULTS

We found that hypermagnesemia was common and associated with a 1.5-fold increased risk of death in the whole cohort. Hyperphosphatemia also increased the risk of death, exactly 2.4-fold. Furthermore, we found a statistically significant association between increased mortality in the whole cohort and hypovitaminosis D3 (P <0.05). Serum creatinine concentration and estimated glomerular filtration ratio significantly correlated with serum magnesium and phosphate levels.

CONCLUSION

Hypermagnesemia, hyperphosphatemia, and hypovitaminosis D but not hypocalcemia influence the mortality of patients with COVID-19. These parameters should be monitored routinely in this group of patients, especially in those with decreased kidney function.

摘要

目的

COVID-19 的非呼吸表现包括内分泌紊乱,其中包括钙镁磷稳态异常,这些异常似乎会影响疾病的严重程度和患者的预后。本研究的目的是评估 COVID-19 住院患者中钙镁磷和维生素 D3 紊乱对生存率的影响,同时考虑疾病严重程度和肾功能。

设计或方法

本研究于 2020 年 4 月至 2021 年 5 月在波兰华沙中央临床医院进行。共纳入了 146 名至少检测了一种研究元素、估计肾小球滤过率、肌酐水平和血液饱和度,并被诊断为 COVID-19 疾病的患者。

结果

我们发现高镁血症很常见,并且与整个队列的死亡风险增加 1.5 倍有关。高磷酸盐血症也会增加死亡风险,正好增加 2.4 倍。此外,我们还发现整个队列中死亡率增加与维生素 D3 缺乏之间存在统计学显著关联(P<0.05)。血清肌酐浓度和估计肾小球滤过率与血清镁和磷水平显著相关。

结论

高镁血症、高磷酸盐血症和维生素 D3 缺乏症而不是低钙血症会影响 COVID-19 患者的死亡率。这些参数应在该组患者中常规监测,特别是在肾功能下降的患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc85/9254648/cfbf1c7f219f/gr1_lrg.jpg

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