Hypokalemia is extremely prevalent amongst sufferers with coronavirus illness 2019 (COVID-19), in line with investigators.
In a examine of 175 sufferers with COVID-19 receiving care at hospitals in Wenzhou, Zhejiang Province, China, 64 (37%) had hypokalemia, 31 (18%) had extreme hypokalemia, and 80 (46%) had normokalemia, Dong Chen, MD, of The Ding Li Scientific Faculty of Wenzhou Medical College, and colleagues reported in JAMA Community Open.
The novel coronavirus that causes COVID-19 — extreme acute respiratory syndrome coronavirus 2 (SARS-CoV-2) — binds to angiotensin-converting enzyme 2 (ACE2). The investigators concluded that the excessive prevalence of hypokalemia amongst sufferers with COVID-19 suggests the presence of disordered renin-angiotensin-system (RAS) exercise, which will increase because of decreased counteractivity of ACE2.
Sufferers with extreme hypokalemia (plasma potassium ranges beneath three mmol/L) have been handled with potassium chloride dietary supplements at a dosage of three g/d, for a complete imply of 34 g of potassium chloride throughout their hospital keep. Three severely sick sufferers with hypokalemia required potassium dietary supplements for 10 to 14 days to have regular normokalemia, whereas three mildly sick sufferers with hypokalemia normokalemia after receiving potassium dietary supplements for five to eight days.
“Due to the attainable results on cardiovascular capabilities, neurohormonal activation, and different important organs by hypokalemia, clinicians ought to take note of hypokalemia and the sufferers’ response to [potassium] dietary supplements,” the authors suggested.
Hypokalemia correction is difficult due to steady renal lack of potassium ensuing from the degradation of ACE2 by the binding of SARSCoV-2, in line with the investigators.
The cessation of potassium loss could also be a dependable, well timed, and delicate biomarker that displays the tip of disruption of the RAS by the coronavirus, they said.
The current examine additionally discovered that the diploma of hypokalemia was related to some scientific options that mirrored the severity of the illness, together with underlying circumstances, excessive physique temperature, and, notably, elevated laboratory indices reflecting myocardial accidents.
Though each gastrointestinal (GI) and urinary lack of potassium may trigger hypokalemia, the examine’s findings recommend that GI loss won't contribute a lot to hypokalemia, the investigators mentioned. Solely a small proportion of sufferers with hypokalemia had GI signs, they famous.
As well as, amongst sufferers with hypokalemia, there have been no variations between these with and with out diarrhea, and most sufferers had delicate diarrhea. “Subsequently, hypokalemia would possibly primarily outcome from elevated urine loss.”
The brand new report provides to rising proof of COVID-19’s antagonistic results on the kidneys. For instance, investigators on the Feinstein Institutes for Medical Analysis in Manhasset, New York, discovered that acute kidney damage (AKI) developed in 1993 (36.6%) of 5449 sufferers hospitalized with COVID-19 at 13 Northwell Well being hospitals within the New York metropolitan space from March 1 to April 5, 2020. In line with the report, which was printed in Kidney Worldwide, AKI was primarily noticed in sufferers with respiratory failure, with AKI growing in 89.7% of sufferers on mechanical air flow in contrast with 21.7% of sufferers not requiring air flow.
This text initially appeared on Renal and Urology News