Electrolyte imbalances in patients with severe coronavirus disease 2019 (COVID-19).
Electrolyte imbalances in patients with severe coronavirus disease 2019 (COVID-19).
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2019年严重冠状病毒病患者（COVID-19）患者的电解质失衡。
DOI：
10.1177/0004563220922255
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发表时间：
2020-05
影响因子：
2.2
通讯作者：
Henry BM
中科院分区：
文献类型：
--
作者：
Lippi G;South AM;Henry BM
早期的研究报告了进展为2019冠状病毒病（COVID-19）严重形式的患者在入院时的各种电解质异常。由于电解质失衡不仅可能影响患者护理，而且还可以深入了解COVID-19的病理生理学，因此我们的目的是分析所有报告的COVID-19患者（有和无重度）电解质的早期数据。对Medline（PubMed界面）、Scopus和Web of Science进行了电子检索，以查找比较COVID-19伴和不伴严重疾病患者之间电解质（钠、钾、氯和钙）的文章。进行汇总分析以估计加权平均差异（WMD）和95%置信区间。5项研究，总样本量为1415名COVID-19患者。重度COVID-19患者的钠水平显著较低（WMD：−0.91 mmol/L [95% CI：−1.33至−0.50 mmol/L]）。同样，在患有严重疾病的COVID-19患者中，钾也显著降低（WMD：−0.12 mmol/L [95%CI：−0.18至−0.07 mmol/L]，I2=33%）。对于氯化物，重度和非重度COVID-19患者之间未观察到统计学差异（WMD：0.30 mmol/L [95%CI：-0.41至1.01 mmol/L]）。对于钙，在重度COVID-19患者中观察到具有统计学意义的较低浓度（WMD：−0.20 mmol/L [95% CI：−0.25至−0.20 mmol/L]）。这项汇总分析证实，COVID-19的严重程度与血清钠、钾和钙浓度降低有关。我们建议在初次就诊时测量电解质，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。
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 analyze all early data reported on electrolytes in COVID-19 patients with and without severe form. 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. 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]). 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.
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