Relationship between kalemia and intensive care unit admission or death in hospitalized COVID-19 patients: A cohort study

A F Guédon; A Delarue; N Mohamedi; A Roffé; L Khider; N Gendron; G Goudot; G Détriché; R Chocron; S Oudard; D M Smadja; T Mirault; E Messas

doi:10.1016/j.jdmv.2021.10.006

Relationship between kalemia and intensive care unit admission or death in hospitalized COVID-19 patients: A cohort study

J Med Vasc. 2022 Feb;47(1):3-10. doi: 10.1016/j.jdmv.2021.10.006. Epub 2021 Nov 1.

Authors

A F Guédon¹, A Delarue², N Mohamedi², A Roffé², L Khider³, N Gendron⁴, G Goudot³, G Détriché³, R Chocron⁵, S Oudard⁶, D M Smadja⁷, T Mirault³, E Messas³

Affiliations

¹ Vascular medicine department, hôpital Européen Georges-Pompidou, 20, rue Leblanc, Paris, France. Electronic address: emmanuel.messas@aphp.fr.
² Vascular medicine department, hôpital Européen Georges-Pompidou, 20, rue Leblanc, Paris, France.
³ Vascular medicine department, hôpital Européen Georges-Pompidou, 20, rue Leblanc, Paris, France; UMR 970 PARCC Inserm, Paris University, Paris, France.
⁴ Université de Paris, Innovative Therapies in Hemostasis, Inserm, 75006 Paris, France.
⁵ UMR 970 PARCC Inserm, Paris University, Paris, France; Emergency department, AP-HP, Paris University, Paris, France.
⁶ Oncology department, AP-HP, Paris University, Paris, France.
⁷ Université de Paris, Innovative Therapies in Hemostasis, Inserm, 75006 Paris, France; Hematology department and Biosurgical Research lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, 75015 Paris, France.

Abstract

Background: SARS-CoV-2 uses Angiotensin-Converting Enzyme 2 as a viral gateway to the cell and could interact with the renin-angiotensin-aldosterone system. Other studies have shown kalemia abnormalities in patients with severe forms of coronavirus disease 2019. Our goal was to assess the prognosis value of kalemia within ten days of symptom offset in the COVID-19 hospitalized population.

Methods: We analyzed data from a prospective cohort that included 65 patients with COVID-19, admitted between March 15, 2020, and March 21, 2020. The study aimed at determining the relationship between baseline kalemia and the admission to an intensive care unit (ICU) or death.

Results: The median age of the patients was 65 [54-79] years old, and 66.2% of the patients were men. Baseline kalemia under 3.8mmol/l occurred in 31 patients (48%), including 11 patients (35.5%) who were admitted to an ICU and one patient (3.2%) who died before ICU admission. In the primary end-point analysis, the adjusted hazard ratios for admission to an ICU or death were 3.52 [95% confidence interval (CI), 1.12 to 11.04] among patients with low baseline kalemia.

Conclusion: Our study suggests that low kalemia levels within ten days of the first symptom onset might be associated with an increased risk of intensive care unit admission or death. The future perspective should be to better understand this relationship.

Keywords: COVID-19; Coronavirus; Hypokalemia; ICU; Prognosis; SARS-CoV-2.

MeSH terms

Aged
COVID-19*
Cohort Studies
Humans
Intensive Care Units
Male
Middle Aged
Prospective Studies
SARS-CoV-2