Association Between Average Plasma Potassium Levels and 30-day Mortality During Hospitalization in Patients with COVID-19 in Wuhan, China.
Association Between Average Plasma Potassium Levels and 30-day Mortality During Hospitalization in Patients with COVID-19 in Wuhan, China.
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DOI：
10.7150/ijms.50965
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发表时间：
2021
影响因子：
3.6
通讯作者：
Li J
中科院分区：
文献类型：
--
作者：
Liu S;Zhang L;Weng H;Yang F;Jin H;Fan F;Zheng X;Yang H;Li H;Zhang Y;Li J
背景：自2019年12月以来，2019冠状病毒病（COVID-19）已导致全球超过61万人死亡。鉴于患者死亡前病情迅速恶化，迫切需要具有有效预后价值的标记物。在治疗过程中，在重症患者中观察到血浆钾水平的显著变化。我们旨在评估COVID-19患者住院期间平均血浆钾（Ka+）水平与30天死亡率之间的关系。研究方法：本研究入组了2020年2月8日至28日在中国武汉同济医院中法新城分支住院的COVID-19感染患者。我们对患者进行了长达30天的随访。结果：共有136例患者纳入研究。平均年龄为62.1 ± 14.6岁，51.5%的患者为男性。中位基线钾水平为4.3（3.9 - 4.6）mmol/L，住院期间Ka+水平为4.4（4.2 - 4.7）mmol/L;我们测量钾的中位次数为4（3 - 5）。30天死亡率为19.1%。Ka+与30天死亡率之间呈J形相关。多因素考克斯回归分析显示，与对照组相比，（Ka +4.0~<4.5 mmol/L），30 d死亡率为1.99（95%置信区间[CI]= 0.54 - 7.35，P = 0.300），1.14 Ka +<4.0、4.5~<5.0和≥ 5.0 mmol/L的COVID-19患者分别高4.14倍（95% CI = 0.39 - 3.32，P = 0.810）和4.14倍（95% CI = 1.29 - 13.29，P = 0.017）。结论：与Ka+水平4.0至<4.5 mmol/L的患者相比，Ka+水平≥ 5.0 mmol/L的COVID-19患者的30天死亡率显着增加。应定期监测COVID-19患者的血浆钾水平，并将其维持在适当范围内。
Background: Coronavirus disease 2019 (COVID-19) has resulted in more than 610,000 deaths worldwide since December 2019. Given the rapid deterioration of patients' condition before death, markers with efficient prognostic values are urgently required. During the treatment process, notable changes in plasma potassium levels have been observed among severely ill patients. We aimed to evaluate the association between average plasma potassium (Ka+) levels during hospitalization and 30-day mortality in patients with COVID-19. Methods: Consecutive patients with COVID-19 hospitalized in the Zhongfaxincheng branch of Tongji Hospital in Wuhan, China from February 8 to 28, 2020 were enrolled in this study. We followed patients up to 30 days after admission. Results: A total of 136 patients were included in the study. The average age was 62.1±14.6 years and 51.5% of patients were male. The median baseline potassium level was 4.3 (3.9-4.6) mmol/L and Ka+ level during hospitalization was 4.4 (4.2-4.7) mmol/L; the median number of times that we measured potassium was 4 (3-5). The 30-day mortality was 19.1%. A J-shaped association was observed between Ka+ and 30-day mortality. Multivariate Cox regression showed that compared with the reference group (Ka+ 4.0 to <4.5 mmol/L), 30-day mortality was 1.99 (95% confidence interval [CI]=0.54-7.35, P=0.300), 1.14 (95% CI=0.39-3.32, P=0.810), and 4.14 (95% CI=1.29-13.29, P=0.017) times higher in patients with COVID-19 who had Ka+ <4.0, 4.5 to <5.0, and ≥5.0 mmol/L, respectively. Conclusion: Patients with COVID-19 who had a Ka+ level ≥5.0 mmol/L had a significantly increased 30-day mortality compared with those who had a Ka+ level 4.0 to <4.5 mmol/L. Plasma potassium levels should be monitored routinely and maintained within appropriate ranges in patients with COVID-19.
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