Icahn School of Medicine at Mount Sinai, NYC Health and Hospitals, Queens, NY, USA.
Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, NY, USA.
Medicine (Baltimore). 2024 May 17;103(20):e37749. doi: 10.1097/MD.0000000000037749.
There are multiple mechanisms by which The Coronavirus-19 (COVID-19) infection can cause electrolyte abnormalities, which may not be the case for bacterial causes of pneumonia. This study aimed to assess the differences in electrolyte levels between patients suffering from COVID-19 and bacterial pneumonia. This is an original, retrospective study. Two cohorts of hospitalized patients were included, 1 suffering from COVID-19 and the other from bacterial pneumonia. Their day 1 and day 3 levels of sodium, potassium, magnesium, and phosphorus, as well as their outcomes, were extracted from the charts. Statistical analysis was subsequently performed. Mean admission levels of sodium, potassium, phosphorus, and magnesium were 135.64 ± 6.13, 4.38 ± 0.69, 3.53 ± 0.69, and 2.03 ± 0.51, respectively. The mean day 3 levels of these electrolytes were 138.3 ± 5.06, 4.18 ± 0.59, 3.578 ± 0.59, and 2.11 ± 0.64, respectively. Patients suffering from bacterial pneumonia were significantly older (N = 219, mean = 64.88 ± 15.99) than patients with COVID-19 pneumonia (N = 240, mean = 57.63 ± 17.87). Bacterial pneumonia group had significantly higher serum potassium (N = 211, mean = 4.51 ± 0.76), and magnesium (N = 115, mean = 2.12 ± 0.60) levels compared to COVID-19 group (N = 227, mean = 4.254 ± 0.60 for potassium and N = 118, mean = 1.933 ± 0.38 for magnesium). Only magnesium was significantly higher among day 3 electrolytes in the bacterial pneumonia group. No significant association between electrolyte levels and outcomes was seen. We found that COVID-19 patients had lower potassium and magnesium levels on admission, possibly due to the effect of COVID-19 on the renin-angiotensin-aldosterone system as well as patient characteristics and management. We did not find enough evidence to recommend using electrolyte levels as a determinator of prognosis, but more research is needed.
新型冠状病毒(COVID-19)感染可导致电解质异常的机制有很多,而细菌引起的肺炎则不然。本研究旨在评估 COVID-19 患者和细菌性肺炎患者之间电解质水平的差异。这是一项原始的回顾性研究。纳入了两组住院患者,一组患有 COVID-19,另一组患有细菌性肺炎。从病历中提取了他们入院第 1 天和第 3 天的钠、钾、镁和磷水平及其转归。随后进行了统计分析。入院时钠、钾、磷和镁的平均水平分别为 135.64±6.13、4.38±0.69、3.53±0.69 和 2.03±0.51,第 3 天的平均水平分别为 138.3±5.06、4.18±0.59、3.578±0.59 和 2.11±0.64。患有细菌性肺炎的患者明显比患有 COVID-19 肺炎的患者年龄更大(N=219,平均年龄=64.88±15.99),比患有 COVID-19 肺炎的患者(N=240,平均年龄=57.63±17.87)。与 COVID-19 组(N=227,钾的平均水平为 4.254±0.60,N=118,镁的平均水平为 1.933±0.38)相比,细菌性肺炎组(N=211,钾的平均水平为 4.51±0.76,N=115,镁的平均水平为 2.12±0.60)的血清钾和镁水平明显更高。只有第 3 天的镁在细菌性肺炎组中明显更高。电解质水平与结局之间未见显著相关性。我们发现 COVID-19 患者入院时的钾和镁水平较低,这可能是由于 COVID-19 对肾素-血管紧张素-醛固酮系统以及患者特征和管理的影响。我们没有发现足够的证据推荐使用电解质水平作为预后的决定因素,但需要进一步研究。