Electrolyte concentration in blood serum as prognostic of severe course COVID-19

THE AIM. To study the key homeostatic physicochemical parameters of blood serum characterizing the patient's state with COVID-19 of varying severity. Patients and methods. The study involved 94 patients with COVID-19, age from 24 to 102 years, median – 67 years, men – 43, women – 51. Patients were divided into 3 groups: 1st – 40 patients with a relatively mild course, 2nd – 22 patients with a severe course of the disease, after treatment they were discharged from the clinic, the 3rd – 32 patients with a very severe course of COVID-19 and a fatal outcome. The concentration of ions in blood serum was measured on a Gem Premier 3000 (Instrumentation Laboratory, USA), clinical analysis was performed on a BC-5380c Mindray hematology analyzer (Mindray, China), biochemical studies were performed on an Architech c4000 analyzer (Abbott Laboratories, USA). RESULTS. The harbingers of a serious impairment in patients with COVID-19 were an increase in the Na+/K+ ratio in blood serum from 32,7±0,8 to 44,7 ± 2.1 (p<0,01), a decrease in the concentration of ionized Ca2+ from 1,08 ± 0,01 to 0,9 ± 0,03 mmol/l (p<0,01), a sharp increase in the concentration of C-reactive protein from 43,6±8,6 to 175 ± 14,7 mg/l (p<0,01). Within the reference values with COVID-19 the concentration of bilirubin and creatinine in the blood serum remained normal; the concentration of total protein was at the lower limits of the normal range, the glucose level was slightly higher than normal, and ferritin was increased compared to the reference values. CONCLUSION. Harbingers of a sharp impairment in COVID-19 are an increase in the Na+/K+ ratio in the blood serum, a decrease of the of ionized Ca2+ concentration, a sharp increase in C-reactive protein concentration.