Background

Early studies have reported various electrolyte abnormalities at admission in patients who progress to the severe form of coronavirus disease 2019 (COVID-19). As electrolyte imbalance may not only impact patient care, but provide insight into the pathophysiology of COVID-19, we aimed to analyse all early data reported on electrolytes in COVID-19 patients with and without severe form.

Methods

An electronic search of Medline (PubMed interface), Scopus and Web of Science was performed for articles comparing electrolytes (sodium, potassium, chloride and calcium) between COVID-19 patients with and without severe disease. A pooled analysis was performed to estimate the weighted mean difference (WMD) with 95% confidence interval.

Results

Five studies with a total sample size of 1415 COVID-19 patients. Sodium was significantly lower in patients with severe COVID-19 (WMD: –0.91 mmol/L [95% CI: –1.33 to –0.50 mmol/L]). Similarly, potassium was also significantly lower in COVID-19 patients with severe disease (WMD: –0.12 mmol/L [95% CI: –0.18 to –0.07 mmol/L], I²=33%). For chloride, no statistical differences were observed between patients with severe and non-severe COVID-19 (WMD: 0.30 mmol/L [95% CI: –0.41 to 1.01 mmol/L]). For calcium, a statistically significant lower concentration was noted in patients with severe COVID-19 (WMD: –0.20 mmol/L [95% CI: –0.25 to –0.20 mmol/L]).

Conclusions

This pooled analysis confirms that COVID-19 severity is associated with lower serum concentrations of sodium, potassium and calcium. We recommend electrolytes be measured at initial presentation and serially monitored during hospitalization in order to establish timely and appropriate corrective actions.

中文翻译：

---

严重冠状病毒病2019（COVID-19）患者的电解质失衡。

背景

早期研究报告说，进入严重冠状病毒病2019（COVID-19）的患者入院时会出现各种电解质异常。由于电解质失衡不仅会影响患者的护理，而且会提供对COVID-19病理生理的深入了解，因此我们旨在分析所有报道的无论有无严重形式的COVID-19患者中有关电解质的所有早期数据。

方法

对Medline（PubMed界面），Scopus和Web of Science进行了电子搜索，以比较具有和没有严重疾病的COVID-19患者之间的电解质（钠，钾，氯和钙）。进行汇总分析以估计置信区间为95％的加权平均差（WMD）。

结果

五项研究的总样本量为1415名COVID-19患者。严重COVID-19的患者中钠的含量显着降低（WMD：–0.91 mmol / L [95％CI：–1.33至–0.50 mmol / L]）。同样，患有严重疾病的COVID-19患者的钾含量也显着降低（WMD：–0.12 mmol / L [95％CI：–0.18至–0.07 mmol / L]，I ² = 33％）。对于氯化物，重度和非重度COVID-19患者之间无统计学差异（WMD：0.30 mmol / L [95％CI：–0.41至1.01 mmol / L]）。对于钙，重度COVID-19患者中的钙浓度在统计学上显着降低（WMD：–0.20 mmol / L [95％CI：–0.25至–0.20 mmol / L]）。

结论

这项汇总分析证实了COVID-19的严重程度与较低的钠，钾和钙的血清浓度有关。我们建议在初次就诊时对电解质进行测量，并在住院期间进行连续监测，以便及时采取适当的纠正措施。