(542) Electrolyte Imbalance and Clinical Outcomes in Hospitalized COVID-19 Patients

Introduction: Electrolyte imbalance is associated with increased morbidity and mortality among critically ill coronavirus disease 2019 (COVID-19) patients. This study aimed to investigate the role of specific electrolytes in influencing patient outcomes.

Methods: Retrospective analysis of COVID-19 patients who were admitted to a single center in Houston, Texas between March 2020 and February 2022. Patients were divided into: Group 1 (Balanced electrolytes) and Group 2 (Imbalanced electrolytes). Prevalence, and outcomes of electrolyte disorders were analyzed. We defined electrolyte imbalances as: Sodium < 135 mmol/L or sodium >145 mmol/L or potassium < 3.5 mmol/L or potassium >5.2, or chloride < 98 mmol/L or chloride >108 or magnesium < 1.7 or magnesium >2.2 or phosphorus < 2.8 or phosphorus >4.5 or calcium < 8.6 or calcium >10.3. Data was assessed using IBM SPSS Statistics version 24.0, and employing descriptive statistics and Chi-square tests to ascertain statistical significance.

Results: A total of 953 patients were included in this analysis. The median age was 56 years [44-67], and 541 (56%) were men. Median hospitalization duration was 7 days [4-12].179 patients (18.7%) died. The median level of sodium was 136 [133-138], potassium 3.9 [3.6-4.3], chloride 101 [98-104], calcium 8.6 [8.2-9], phosphorus 3.1 [2.6-.7] and magnesium 2 [1.8-2.2]. Ninety-four (16.5%) patients without a sodium imbalance and 85 (22.2%) with a sodium imbalance died; p=0.027. One hundred twenty-two (16.4%) patients without chloride imbalance and 57 (27.5%) with a chloride imbalance died; p< 0.001. For potassium, 153 (19.3%) patients without imbalance died and 26 (16.1%) with an imbalance died; p=0.348. With regards to calcium 67 (13.4%) patients without imbalance and 112 (24.8%) with an imbalance died p< 0.001. Regarding phosphorus, 96 (15.9%) without imbalance and 83(23.9%) patients with imbalance died p=0.002. Magnesium showed that 111 (17%) patients without imbalance and 68 (22.7%) with imbalance died p=0.037.

Conclusions: Sodium, chloride, calcium and phosphorus imbalances were significantly associated with higher mortality rates in COVID-19 patients. However, potassium and magnesium imbalances did not exhibit statistically significant differences in mortality rates.