Evaluation of Pattern and Impact of Electrolytes Abnormalities in Critically Ill Covid-19 Patients

Abstract

OBJECTIVE: To evaluate the pattern of serum electrolytes abnormalities and their impact on ICU admitted Covid-19 patient outcomes. METHODOLOGY: This retrospective study was carried out at OMI hospital and Dr. Ziauddin Hospital, Karachi, Pakistan, between August to December 2020. Total 102 PCR positive, ICU admitted with severe Covid-19 patients as per WHO criteria were included. The patient's demographic characteristics, clinical features including co-morbidities, electrolytes reports at the time of admission, length of ICU and/or hospital stay, and outcome (expired/survived) were evaluated. RESULTS: Biochemical testing found abnormal electrolyte levels in 90.2% ICU admitted Covid-19 patients. Electrolytes abnormalities including hyponatremia 45.1%, hypermagnesemia 40.2%, hypocalcemia 31.4%, hyperchloremia23.5% and hyperphosphatemia in 20.6% patients. Out of the total, 28.4% of patients needed invasive respiratory support, and 37.3% could not survive. A higher incidence of mortality (39.1% vs. 20%) was seen in patients with electrolytes abnormalities compared to those presented with normal values. CONCLUSION: Electrolyte abnormalities were found in 90% of the ICU Admitted Covid-19 patients. The most common abnormalities found among the patients were hyponatremia, hypermagnesemia, and Hypocalcemia. The findings revealed that several electrolyte imbalances harm patients' in-hospital outcomes. Electrolyte assessment of Covid-19 patients at the time of admission would be helpful in risk stratification for adverse outcomes.