Dyschloremia During Severe COVID‑19 Infection in Intensive Care Unit Patients

Maryam Gheraati, M. Mirzadeh, Fatemeh Nazifi, Negar Sheikhdavoodi, Atefeh Khoshkchali
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Abstract

Background: Dyschloremia is one of the most prevalent abnormalities that is highly associated with a high level of mortality in intensive care unit (ICU) patients. The current study evaluated serum chloride levels in COVID-19 patients hospitalized in the ICU. Methods: This cross-sectional study was conducted on 245 patients with severe COVID-19 who were admitted to the intensive care unit (ICU). Electrolytes, albumin, liver function test, complete blood count, serum chloride, and VBG were among the laboratory markers compared. The Chi-square, t-test, and logistic regression models were used to examine the relationship between these markers and the key outcomes, which included severity, mortality, intubation, and hospitalization. Findings: The Mean±SD age of patients was 58.16±17 years. The mean serum chloride level in the studied patients was 109.6±5.1 with a range of 100-134. According to the regression logistic model, variables like age, intubation status, pH, and chlorine levels significantly affected the outcome of COVID-19 disease. Patients with acidosis were 4.7 times more likely to die than those with alkalosis (P<0.001). The chance of dying in hyperchloremia is 2.38 times more compared to the normochloremia group (P<0.009). Conclusion: Patients with severe COVID-19 may present with chlorine abnormalities, including hyperchloremia. Hyperchloremia is also associated with poor clinical outcomes and a higher mortality risk. This relationship was independent of acid-base disorder.
重症监护病房患者重症COVID - 19感染期间的精神障碍者
背景:在重症监护病房(ICU)患者中,精神障碍性贫血是最普遍的异常之一,与高死亡率高度相关。目前的研究评估了在ICU住院的COVID-19患者的血清氯化物水平。方法:对245例重症监护病房(ICU)重症COVID-19患者进行横断面研究。电解质、白蛋白、肝功能、全血细胞计数、血清氯化物和VBG是比较的实验室指标。使用卡方检验、t检验和逻辑回归模型来检验这些标志物与关键结局(包括严重程度、死亡率、插管和住院)之间的关系。结果:患者平均±SD年龄为58.16±17岁。研究患者的平均血氯水平为109.6±5.1,范围为100-134。根据回归logistic模型,年龄、插管状态、pH、氯浓度等变量显著影响COVID-19疾病的预后。酸中毒患者的死亡率是碱中毒患者的4.7倍(P<0.001)。高氯血症组的死亡率是正常氯血症组的2.38倍(P<0.009)。结论:重症COVID-19患者可能存在氯异常,包括高氯血症。高氯血症还与较差的临床结果和较高的死亡风险相关。这种关系与酸碱紊乱无关。
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