Hadavi Marzieh, Taghinezhad Fakhredin, Shafiei Elham, Babakr Sharif Hama, Bastaminejad Saiyad, Kaffashian Mohammadreza, Ahmadi Iraj, Mozafari Aliashraf
Department of Internal Medicine, School of Medicine, Shahid Mostafa Khomeini Hospital, Ilam University of Medical Sciences, Ilam, Iran.
Clinical Research Development Unit, Shahid Mostafa Khomeini Hospital, Ilam University of Medical Sciences, Ilam, Iran.
Int J Endocrinol Metab. 2022 Jul 12;20(3):e126386. doi: 10.5812/ijem-126386. eCollection 2022 Jul.
Electrolyte imbalances are common in COVID-19 infection and are associated with poor outcomes in hospitalized patients.
This study examined whether serum phosphate imbalances at admission are associated with mortality in hospitalized COVID-19 patients.
In this registry-based single-center retrospective cohort study, 1349 inpatients with COVID-19 were included from March 2020 to March 2021 in an academic hospital in Ilam (southwest Iran). The Cox proportional hazard (PH) regression model was applied to the data set of COVID-19.
The in-hospital median survival time for patients with low, normal, and high serum phosphate levels was 14, 25, and 8 days, respectively. In a multivariate model, adjusted for the other variables, patients with hypophosphatemia (adjusted hazard ratio [HR], 2.53; 95% CI, 1.15 - 5.58; P = 0.02) and hyperphosphatemia (adjusted HR, 1.77; 95% CI, 1.00 - 3.14; P = 0.05) had an increased mortality hazard compared with those who had normal levels of serum phosphate.
Our results demonstrate associations of hypophosphatemia and hyperphosphatemia with increased in-hospital mortality in COVID-19 patients. Intensive medical care and more attention must be paid to COVID-19 patients with serum phosphate imbalances at admission.
电解质失衡在新型冠状病毒肺炎（COVID-19）感染中很常见，并且与住院患者的不良预后相关。
本研究旨在探讨入院时血清磷酸盐失衡是否与COVID-19住院患者的死亡率相关。
在这项基于登记的单中心回顾性队列研究中，纳入了2020年3月至2021年3月在伊朗西南部伊拉姆一家学术医院的1349例COVID-19住院患者。将Cox比例风险（PH）回归模型应用于COVID-19数据集。
血清磷酸盐水平低、正常和高的患者在院内的中位生存时间分别为14天、25天和8天。在多变量模型中，对其他变量进行校正后，与血清磷酸盐水平正常的患者相比，低磷血症患者（校正风险比[HR]，2.53；95%CI，1.15 - 5.58；P = 0.02）和高磷血症患者（校正HR，1.77；95%CI，1.00 - 3.14；P = 0.05）的死亡风险增加。
我们的结果表明，低磷血症和高磷血症与COVID-19患者院内死亡率增加有关。对于入院时血清磷酸盐失衡的COVID-19患者，必须给予强化医疗护理并予以更多关注。
