Low serum potassium among patients with COVID-19 in Bangkok, Thailand: Coincidence or clinically relevant?

Abstract

Our cross-sectional study estimated the prevalence and clinical relevance of hypokalaemia among confirmed COVID-19 cases admitted in three hospitals in Bangkok during the early outbreak in Thailand. Of 36 patients, nine were in the hypokalaemia group (25%) and 27 in the normokalaemia group (75%). All cases were asymptomatic, and 94.4% had mild hypokalaemia. Hypokalaemia was found significantly earlier in the course of COVID-19 without evidence of significant extrarenal potassium loss. Body temperature and mean serum sodium in the hypokalaemia group tended to be higher than the normokalaemia group. Hypokalaemia and potentially higher serum sodium among COVID-19 patients were the remarkable findings. This issue warrants for further investigation.

Higher admission activated partial thromboplastin time, neutrophil-lymphocyte ratio, serum sodium, and anticoagulant use predict in-hospital COVID-19 mortality in people with Diabetes: Findings from Two University Hospitals in the U.K

“…However, we specifically collected detailed data on vital signs including respiratory rate, albumin status, serum sodium, potassium and renal function, total leukocyte counts and subsets including neutrophils and lymphocytes, and coagulation profiles. This was in keeping with our hypothesis and aims and based on emerging literature linking these characteristics with morbidity and mortality in COVID-19 [15] , [16] , [17] , [18] , [19] , [20] . Demographic, clinical and laboratory data were extracted using computer search algorithms from electronic medical records and by the investigators from paper case notes.…”

Epidemiology, prognosis and management of potassium disorders in Covid‐19

“…A numbers of studies have reported hypokalemia as an important clinical manifestation of this new coronavirus 14,19,21,47–49 . Chen et al.…”

Associations and prognostic accuracy of electrolyte imbalances in predicting poor COVID-19 outcome: a systematic review and meta-analysis

“…One study measured electrolyte levels at COVID-19 diagnosis and one study recorded the imbalance at any time during hospitalization. [20,48] As some studies measured electrolyte levels beyond 24 hours, [14,22,47,54] we excluded them in sensitivity analyses. This did not did not alter our conclusions.…”

“…[14,21,39] Dyskalemia Nine and two studies investigated the association of hypokalemia and hyperkalemia with the same COVID-19 outcomes respectively (Table 1). [20,23,24,40,44,[46][47][48]52] Majority of studies defined hypokalemia and hyperkalemia as having a serum potassium level of < 3.5 mmol/L or > 5.1 mmol/L respectively. Three studies further stratified their sample based on hypokalemia severity.…”

“…Of the 28 included studies (Table 1), 21 were retrospective cohorts, [14, 20, 21, 23, 24, 39-47, 49, 51, 53-57] four were prospective cohorts,[22, [36][37][38] two were cross-sectional [48,52] and one was a case-control study. [50] Sensitivity analyses excluding non-cohort studies did not change our findings substantially.…”