Hypophosphatemia: Unraveling a lethal connection with icu mortality in critically ill COVID-19 patients: a multicenter observational study.

IF 2 4区医学 Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY

Journal of Medical Biochemistry Pub Date : 2025-03-21 DOI:10.5937/jomb0-52474

Şahin Temel, Pervin Hanci, Akbudak Ismail Hakkı, Burçin Halaçli, Göksel Güven, Yeliz Bilir, Yüksel Recep Civan, Ezgi Özyilmaz, Neriman Defne Altintaş, Leyla Ferliçolak, Emre Aydin, Türkay Akbaş, Ali Ümit Esbah, Zuhal Güllü, Kamil Inci, Gülseren Elay, Arzu Topeli, Kürşat Gündoğan

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引用次数: 0

Abstract

Background: Despite a lack of sufficient knowledge about the prevalence and impact of hypophosphatemia in critically ill COVID-19 patients, organ dysfunction, adverse clinical outcomes, and increased mortality have been consistently associated with hypophosphatemia across diverse patient populations. This retrospective, observational study aimed to investigate hypophosphatemia (HypoP) frequency and establish the correlation between variations in serum phosphorus levels and outcomes in critically ill patients with SARS-CoV-2.

Methods: The research comprised 205 patients diagnosed with COVID-19 confirmed via RT-PCR. The study included COVID-19 patients who experienced respiratory failure and were in intensive care for more than 24 hours, and their phosphorus values were accurately documented. Clinical para meters, comorbidities, respiratory support requirements, and laboratory findings were analysed.

Results: The study participants had a median age of 64 (IQR: 54-75 years), with hypertension being the most pre - valent chronic disease (46%). During the first three days of intensive care, 33% of the participants received conventional oxygen support, whereas 54% required intubation and mechanical ventilation (MV). During this period, hypophosphatemia was noted in 25% of patients, with an ICU admission median serum phosphorus level of 1.02 (0.87-1.25) mmol/L. The median duration of stay in the intensive care unit (ICU) was 7 days, significantly extended in patients with hypophosphatemia (p=0.046). Phosphorus levels on the third day of ICU stay were an independent predictor of ICU mortality. (COX, HR=1.48, 95% CI=1.11-1.98, p=0.006).

Conclusions: During the first three days of ICU admission, 25% of SARS-CoV-2 critically ill adult patients presented with hypophosphatemia. This condition was found to increase ICU mortality rates and prolong ICU stays. Therefore, it is crucial to monitor serum phosphorus levels in the care of critically ill COVID-19 patients.

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低磷血症：揭示COVID-19危重患者icu死亡率的致命联系：一项多中心观察性研究

背景：尽管对COVID-19危重症患者低磷血症的患病率和影响缺乏足够的了解，但在不同的患者群体中，器官功能障碍、不良临床结局和死亡率增加始终与低磷血症相关。本回顾性观察性研究旨在调查SARS-CoV-2危重患者低磷血症（HypoP）频率，并建立血清磷水平变化与预后之间的相关性。方法：本研究纳入205例经RT-PCR确诊的新冠肺炎患者。该研究包括经历呼吸衰竭并在重症监护超过24小时的COVID-19患者，并准确记录了他们的磷值。分析了临床参数、合并症、呼吸支持需求和实验室结果。结果：研究参与者的中位年龄为64岁（IQR: 54-75岁），高血压是最常见的慢性疾病（46%）。在重症监护的前三天，33%的参与者接受了常规氧支持，而54%的参与者需要插管和机械通气（MV）。在此期间，25%的患者出现低磷血症，ICU入院时血清磷水平中位数为1.02 (0.87-1.25)mmol/L。重症监护病房（ICU）的中位住院时间为7天，低磷血症患者的中位住院时间明显延长（p=0.046）。ICU住院第3天的磷水平是ICU死亡率的独立预测因子。（COX， HR=1.48, 95% CI=1.11-1.98, p=0.006）。结论：在ICU收治的前3天，25%的SARS-CoV-2重症成人患者出现低磷血症。发现这种情况增加了ICU死亡率并延长了ICU的住院时间。因此，监测血清磷水平在COVID-19危重症患者的护理中至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Medical Biochemistry BIOCHEMISTRY & MOLECULAR BIOLOGY-

CiteScore

3.00

自引率

12.00%

发文量

审稿时长

>12 weeks

期刊介绍： The JOURNAL OF MEDICAL BIOCHEMISTRY (J MED BIOCHEM) is the official journal of the Society of Medical Biochemists of Serbia with international peer-review. Papers are independently reviewed by at least two reviewers selected by the Editors as Blind Peer Reviews. The Journal of Medical Biochemistry is published quarterly. The Journal publishes original scientific and specialized articles on all aspects of clinical and medical biochemistry, molecular medicine, clinical hematology and coagulation, clinical immunology and autoimmunity, clinical microbiology, virology, clinical genomics and molecular biology, genetic epidemiology, drug measurement, evaluation of diagnostic markers, new reagents and laboratory equipment, reference materials and methods, reference values, laboratory organization, automation, quality control, clinical metrology, all related scientific disciplines where chemistry, biochemistry, molecular biology and immunochemistry deal with the study of normal and pathologic processes in human beings.