Hypokalemia and Its Correlates Among Nigerian SARS-CoV-2 Infected Patients

Bright Amadi; Stephenson Lawson; Collins Amadi

doi:doi:10.11648/j.bs.20220801.14

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Hypokalemia and Its Correlates Among Nigerian SARS-CoV-2 Infected Patients

Bright Amadi, Stephenson Lawson, Collins Amadi

Published in Biomedical Sciences (Volume 8, Issue 1)

Received: 14 January 2022 Accepted: 28 January 2022 Published: 16 February 2022

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Abstract

Background: Disorders of electrolytes balance, especially that of potassium, have frequently been documented among patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, most of these reports have been documented among the western populations. Hence, this current study was aimed to evaluate the pattern of derangement in potassium balance and its correlation to other clinical and laboratory variables among Nigerians. Methods: Archived data of all eligible adult patients, who were managed at the Eleme treatment center in Port Harcourt, Nigeria following a positive real-time reverse-transcriptase polymerase chain reaction (RT-PCR) test for SARS-CoV-2 infection, were enrolled for this study. All relevant data of enrolled subjects were retrieved from the archived case notes, medical review charts, nurses’ charts, and laboratory-related records at initial presentation before any form of medical treatment by trained research assistants using well-structured data extraction forms. The collected data was analyzed using descriptive and comparative statistics. Results: Hypokalemia was recorded in 323 (62.8%) subjects out of a total of 515 eligible subjects. Mild, moderate, and severe hypokalemia was recorded among 32 (9.9%), 219 (67.9%), and 72 (22.2%) subjects, respectively. The subjects with severe hypokalemic status were mostly males and also of older age and had significantly higher systolic blood pressure, CRP, D-dimer, neutrophil count, and higher proportions of those with severe SARS-CoV-2 infection but lower albumin levels, lymphocyte and platelet counts compared to those with mild and moderate hypokalemic status (p<0.05). Inverse relationships were established between plasma potassium status and systolic blood pressure, sodium, C-reactive protein, D-dimer, and neutrophil count. While a significant positive relationship was observed between plasma potassium status and plasma albumin, lymphocyte counts, platelet counts, and oxygen saturation among the hypokalemic subjects (p<0.05). Compare to mild and moderate hypokalemic status, severe hypokalemic status was associated with severe SARS-CoV-2 infection (OR: 5.671; (95%CI: 4.467-7.365); p<0.001) and unfavorable clinical outcomes (OR: 7.863; (95%CI: 6.502-9.342); p<0.001) among the hypokalemic subjects. Conclusion: The present study findings suggest a high frequency of hypokalemia among subjects with the SARS-CoV-2 infection who are mostly males and of older age. The observed hypokalemia, especially the severe variant, was found in association with the severe infection and unfavorable clinical outcome. These findings should be considered during the management of SARS-CoV-2 infection. However, further studies are recommended to verify the conclusions of the present study.

Published in	Biomedical Sciences (Volume 8, Issue 1)
DOI	10.11648/j.bs.20220801.14
Page(s)	20-27
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

SARS-CoV-2, SARS-CoV-2 Infection, COVID-19, Hypokalemia

References

[1]	Nsanzabaganwa C, Byiringiro F, Hitimana N, Mutesa L. The Current Global Trend of COVID-19 Pandemic. Rwanda Pub Health Bull. 2020; 2 (3): 13-5.
[2]	Bhatta T, Mane PM, Bhatt N, Bhatt KB. Global Situation and Trend of COVID-19. J Health Med Econ. 2020; 6 (1): 46.
[3]	Kannan SP, Ali PS, Sheeza A, Hemalatha K. COVID-19 (Novel Coronavirus 2019)-recent trends. Eur Rev Med Pharmacol Sci. 2020; 24 (4): 2006-11.
[4]	Cevik M, Kuppalli K, Kindrachuk J, Peiris M. Virology, transmission, and pathogenesis of SARS-CoV-2. BMJ. 2020; 371: m3862. DOI: 10.1136/bmj.m3862.
[5]	Rabi FA, Al Zoubi MS, Kasasbeh GA, Salameh DM, Al-Nasser AD. SARS-CoV-2 and Coronavirus Disease 2019: What We Know So Far. Pathogens. 2020; 9 (3): 231. DOI: 10.3390/pathogens9030231.
[6]	Turk C, Turk S, Malkan UY, Haznedaroglu IC. Three critical clinicobiological phases of the human SARS-associated coronavirus infections. Eur Rev Med Pharmacol Sci. 2020 Aug; 24 (16): 8606-8620. DOI: 10.26355/eurrev_202008_22660.
[7]	Bourgonje AR, Abdulle AE, Timens W, Hillebrands JL, Navis GJ, Gordijn SJ, et al. Angiotensin-converting enzyme 2 (ACE2), SARS-CoV-2 and the pathophysiology of coronavirus disease 2019 (COVID-19). J Pathol. 2020; 251 (3): 228-248. DOI: 10.1002/path.5471.
[8]	De Carvalho H, Richard MC, Chouihed T, Goffinet N, Le Bastard Q, Freund Y, et al. Electrolyte imbalance in COVID-19 patients admitted to the Emergency Department: a case-control study. Intern Emerg Med. 2021; 16 (7): 1945-1950. DOI: 10.1007/s11739-021-02632-z.
[9]	Alfano G, Ferrari A, Fontana F, Perrone R, Mori G, Ascione E, et al. Hypokalemia in Patients with COVID-19. Clin Exp Nephrol. 2021; 25 (4): 401-9.
[10]	Moreno-P O, Leon-Ramirez JM, Fuertes-Kenneally L, Perdiguero M, Andres M, Garcia-Navarro M, et al. Hypokalemia as a sensitive biomarker of disease severity and the requirement for invasive mechanical ventilation requirement in COVID-19 pneumonia: a case series of 306 Mediterranean patients. Int J Infect Dis. 2020; 100: 449-54.
[11]	Naing L, Winn T, Rusli BN. Practical issues in calculating the sample size for prevalence studies. Arch Orofac Sci. 2006; 1: 9–14.
[12]	Nigerian Centre for Disease Control (NCDC) National Interim Guidelines for Clinical Management of COVID-19. Accessed 9^th January 2022.
[13]	Agana K, Pagana T, Pagana T. Mosby's Diagnostic & Laboratory Test Reference. 14^th ed. United States. Elsevier; 2019.
[14]	Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med. 1999; 130: 461-70.
[15]	Chen D, Li X, Song Q, Hu C, Su F, Dai J, et al. Assessment of hypokalemia and clinical characteristics in patients with coronavirus disease 2019 in Wenzhou, China. JAMA network open. 2020; 3 (6): e2011122.
[16]	Cooper LB, Savarese G, Carrero JJ, Szabo B, Jernberg T, Jonsson A, et al. Clinical and research implications of serum versus plasma potassium measurements. Eur J Heart Fail. 2019; 21 (4): 536-7. DOI: 10.1002/ejhf.1371.
[17]	Lippi G, South AM, Henry BM. Electrolyte imbalances in patients with severe coronavirus disease 2019 (COVID-19). Ann Clin Biochem. 2020; 57 (3): 262-5.
[18]	Pourfridoni M, Abbasnia SM, Shafaei F, Razaviyan J, Heidari-Soureshjani R. Fluid and Electrolyte Disturbances in COVID-19 and Their Complications. Biomed Res Int. 2021; 2021: 6667047. DOI: 10.1155/2021/6667047.
[19]	Inker LA, Titan S. Measurement and estimation of GFR for use in clinical practice: core curriculum 2021. Am J Kidney Dis. 2021; 78 (5): 736-49.
[20]	Liu Y, Yang Y, Zhang C, Huang F, Wang F, Yuan J, et al. Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Sci China Life Sci. 2020; 63 (3): 364–74.
[21]	Sriram K, Insel PA. A hypothesis for pathobiology and treatment of COVID-19: The centrality of ACE1/ACE2 imbalance. Br J Pharmacol. 2020; 177 (21): 4825-4844. DOI: 10.1111/bph.15082.
[22]	Pan L, Mu M, Yang P, Sun Y, Yan J, Li P, et al. Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: a descriptive, cross-sectional, multicenter study. Am J Gastroenterol. 2020. 115: 766–73.

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APA Style

Bright Amadi, Stephenson Lawson, Collins Amadi. (2022). Hypokalemia and Its Correlates Among Nigerian SARS-CoV-2 Infected Patients. Biomedical Sciences, 8(1), 20-27. https://doi.org/10.11648/j.bs.20220801.14

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ACS Style

Bright Amadi; Stephenson Lawson; Collins Amadi. Hypokalemia and Its Correlates Among Nigerian SARS-CoV-2 Infected Patients. Biomed. Sci. 2022, 8(1), 20-27. doi: 10.11648/j.bs.20220801.14

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AMA Style

Bright Amadi, Stephenson Lawson, Collins Amadi. Hypokalemia and Its Correlates Among Nigerian SARS-CoV-2 Infected Patients. Biomed Sci. 2022;8(1):20-27. doi: 10.11648/j.bs.20220801.14

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@article{10.11648/j.bs.20220801.14,
  author = {Bright Amadi and Stephenson Lawson and Collins Amadi},
  title = {Hypokalemia and Its Correlates Among Nigerian SARS-CoV-2 Infected Patients},
  journal = {Biomedical Sciences},
  volume = {8},
  number = {1},
  pages = {20-27},
  doi = {10.11648/j.bs.20220801.14},
  url = {https://doi.org/10.11648/j.bs.20220801.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.bs.20220801.14},
  abstract = {Background: Disorders of electrolytes balance, especially that of potassium, have frequently been documented among patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, most of these reports have been documented among the western populations. Hence, this current study was aimed to evaluate the pattern of derangement in potassium balance and its correlation to other clinical and laboratory variables among Nigerians. Methods: Archived data of all eligible adult patients, who were managed at the Eleme treatment center in Port Harcourt, Nigeria following a positive real-time reverse-transcriptase polymerase chain reaction (RT-PCR) test for SARS-CoV-2 infection, were enrolled for this study. All relevant data of enrolled subjects were retrieved from the archived case notes, medical review charts, nurses’ charts, and laboratory-related records at initial presentation before any form of medical treatment by trained research assistants using well-structured data extraction forms. The collected data was analyzed using descriptive and comparative statistics. Results: Hypokalemia was recorded in 323 (62.8%) subjects out of a total of 515 eligible subjects. Mild, moderate, and severe hypokalemia was recorded among 32 (9.9%), 219 (67.9%), and 72 (22.2%) subjects, respectively. The subjects with severe hypokalemic status were mostly males and also of older age and had significantly higher systolic blood pressure, CRP, D-dimer, neutrophil count, and higher proportions of those with severe SARS-CoV-2 infection but lower albumin levels, lymphocyte and platelet counts compared to those with mild and moderate hypokalemic status (pConclusion: The present study findings suggest a high frequency of hypokalemia among subjects with the SARS-CoV-2 infection who are mostly males and of older age. The observed hypokalemia, especially the severe variant, was found in association with the severe infection and unfavorable clinical outcome. These findings should be considered during the management of SARS-CoV-2 infection. However, further studies are recommended to verify the conclusions of the present study.},
 year = {2022}
}

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TY  - JOUR
T1  - Hypokalemia and Its Correlates Among Nigerian SARS-CoV-2 Infected Patients
AU  - Bright Amadi
AU  - Stephenson Lawson
AU  - Collins Amadi
Y1  - 2022/02/16
PY  - 2022
N1  - https://doi.org/10.11648/j.bs.20220801.14
DO  - 10.11648/j.bs.20220801.14
T2  - Biomedical Sciences
JF  - Biomedical Sciences
JO  - Biomedical Sciences
SP  - 20
EP  - 27
PB  - Science Publishing Group
SN  - 2575-3932
UR  - https://doi.org/10.11648/j.bs.20220801.14
AB  - Background: Disorders of electrolytes balance, especially that of potassium, have frequently been documented among patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, most of these reports have been documented among the western populations. Hence, this current study was aimed to evaluate the pattern of derangement in potassium balance and its correlation to other clinical and laboratory variables among Nigerians. Methods: Archived data of all eligible adult patients, who were managed at the Eleme treatment center in Port Harcourt, Nigeria following a positive real-time reverse-transcriptase polymerase chain reaction (RT-PCR) test for SARS-CoV-2 infection, were enrolled for this study. All relevant data of enrolled subjects were retrieved from the archived case notes, medical review charts, nurses’ charts, and laboratory-related records at initial presentation before any form of medical treatment by trained research assistants using well-structured data extraction forms. The collected data was analyzed using descriptive and comparative statistics. Results: Hypokalemia was recorded in 323 (62.8%) subjects out of a total of 515 eligible subjects. Mild, moderate, and severe hypokalemia was recorded among 32 (9.9%), 219 (67.9%), and 72 (22.2%) subjects, respectively. The subjects with severe hypokalemic status were mostly males and also of older age and had significantly higher systolic blood pressure, CRP, D-dimer, neutrophil count, and higher proportions of those with severe SARS-CoV-2 infection but lower albumin levels, lymphocyte and platelet counts compared to those with mild and moderate hypokalemic status (pConclusion: The present study findings suggest a high frequency of hypokalemia among subjects with the SARS-CoV-2 infection who are mostly males and of older age. The observed hypokalemia, especially the severe variant, was found in association with the severe infection and unfavorable clinical outcome. These findings should be considered during the management of SARS-CoV-2 infection. However, further studies are recommended to verify the conclusions of the present study.
VL  - 8
IS  - 1
ER  -

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Author Information

Bright Amadi

Department of Chemical Pathology, Rivers State University/Rivers State University Teaching Hospital, Port Harcourt, Nigeria
Stephenson Lawson

Department of Medical Microbiology and Parasitology, Rivers State University/Rivers State University Teaching Hospital, Port Harcourt, Nigeria
Collins Amadi

Department of Chemical Pathology, Rivers State University/Rivers State University Teaching Hospital, Port Harcourt, Nigeria

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Bright Amadi, Stephenson Lawson, Collins Amadi. (2022). Hypokalemia and Its Correlates Among Nigerian SARS-CoV-2 Infected Patients. Biomedical Sciences, 8(1), 20-27. https://doi.org/10.11648/j.bs.20220801.14

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ACS Style

Bright Amadi; Stephenson Lawson; Collins Amadi. Hypokalemia and Its Correlates Among Nigerian SARS-CoV-2 Infected Patients. Biomed. Sci. 2022, 8(1), 20-27. doi: 10.11648/j.bs.20220801.14

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AMA Style

Bright Amadi, Stephenson Lawson, Collins Amadi. Hypokalemia and Its Correlates Among Nigerian SARS-CoV-2 Infected Patients. Biomed Sci. 2022;8(1):20-27. doi: 10.11648/j.bs.20220801.14

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@article{10.11648/j.bs.20220801.14,
  author = {Bright Amadi and Stephenson Lawson and Collins Amadi},
  title = {Hypokalemia and Its Correlates Among Nigerian SARS-CoV-2 Infected Patients},
  journal = {Biomedical Sciences},
  volume = {8},
  number = {1},
  pages = {20-27},
  doi = {10.11648/j.bs.20220801.14},
  url = {https://doi.org/10.11648/j.bs.20220801.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.bs.20220801.14},
  abstract = {Background: Disorders of electrolytes balance, especially that of potassium, have frequently been documented among patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, most of these reports have been documented among the western populations. Hence, this current study was aimed to evaluate the pattern of derangement in potassium balance and its correlation to other clinical and laboratory variables among Nigerians. Methods: Archived data of all eligible adult patients, who were managed at the Eleme treatment center in Port Harcourt, Nigeria following a positive real-time reverse-transcriptase polymerase chain reaction (RT-PCR) test for SARS-CoV-2 infection, were enrolled for this study. All relevant data of enrolled subjects were retrieved from the archived case notes, medical review charts, nurses’ charts, and laboratory-related records at initial presentation before any form of medical treatment by trained research assistants using well-structured data extraction forms. The collected data was analyzed using descriptive and comparative statistics. Results: Hypokalemia was recorded in 323 (62.8%) subjects out of a total of 515 eligible subjects. Mild, moderate, and severe hypokalemia was recorded among 32 (9.9%), 219 (67.9%), and 72 (22.2%) subjects, respectively. The subjects with severe hypokalemic status were mostly males and also of older age and had significantly higher systolic blood pressure, CRP, D-dimer, neutrophil count, and higher proportions of those with severe SARS-CoV-2 infection but lower albumin levels, lymphocyte and platelet counts compared to those with mild and moderate hypokalemic status (pConclusion: The present study findings suggest a high frequency of hypokalemia among subjects with the SARS-CoV-2 infection who are mostly males and of older age. The observed hypokalemia, especially the severe variant, was found in association with the severe infection and unfavorable clinical outcome. These findings should be considered during the management of SARS-CoV-2 infection. However, further studies are recommended to verify the conclusions of the present study.},
 year = {2022}
}

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TY  - JOUR
T1  - Hypokalemia and Its Correlates Among Nigerian SARS-CoV-2 Infected Patients
AU  - Bright Amadi
AU  - Stephenson Lawson
AU  - Collins Amadi
Y1  - 2022/02/16
PY  - 2022
N1  - https://doi.org/10.11648/j.bs.20220801.14
DO  - 10.11648/j.bs.20220801.14
T2  - Biomedical Sciences
JF  - Biomedical Sciences
JO  - Biomedical Sciences
SP  - 20
EP  - 27
PB  - Science Publishing Group
SN  - 2575-3932
UR  - https://doi.org/10.11648/j.bs.20220801.14
AB  - Background: Disorders of electrolytes balance, especially that of potassium, have frequently been documented among patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, most of these reports have been documented among the western populations. Hence, this current study was aimed to evaluate the pattern of derangement in potassium balance and its correlation to other clinical and laboratory variables among Nigerians. Methods: Archived data of all eligible adult patients, who were managed at the Eleme treatment center in Port Harcourt, Nigeria following a positive real-time reverse-transcriptase polymerase chain reaction (RT-PCR) test for SARS-CoV-2 infection, were enrolled for this study. All relevant data of enrolled subjects were retrieved from the archived case notes, medical review charts, nurses’ charts, and laboratory-related records at initial presentation before any form of medical treatment by trained research assistants using well-structured data extraction forms. The collected data was analyzed using descriptive and comparative statistics. Results: Hypokalemia was recorded in 323 (62.8%) subjects out of a total of 515 eligible subjects. Mild, moderate, and severe hypokalemia was recorded among 32 (9.9%), 219 (67.9%), and 72 (22.2%) subjects, respectively. The subjects with severe hypokalemic status were mostly males and also of older age and had significantly higher systolic blood pressure, CRP, D-dimer, neutrophil count, and higher proportions of those with severe SARS-CoV-2 infection but lower albumin levels, lymphocyte and platelet counts compared to those with mild and moderate hypokalemic status (pConclusion: The present study findings suggest a high frequency of hypokalemia among subjects with the SARS-CoV-2 infection who are mostly males and of older age. The observed hypokalemia, especially the severe variant, was found in association with the severe infection and unfavorable clinical outcome. These findings should be considered during the management of SARS-CoV-2 infection. However, further studies are recommended to verify the conclusions of the present study.
VL  - 8
IS  - 1
ER  -

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