Prevalence of hypokalemia in COVID-19 and its association with clinical and common laboratory parameters

Authors

  • Md Khairul Islam Junior Consultant, Department of Medicine, Dhaka Medical College Hospital, Dhaka
  • Pratyay Hasan Indoor Medical Officer, Department of Medicine, Dhaka Medical College Hospital, Dhaka
  • Md Murad Hossain Associate Professor, Department of Medicine, Dhaka Medical College, Dhaka
  • Fahima Sharmin Hossain Medical Officer, National Institute of Mental Health, Dhaka
  • Tazdin Delwar Khan Honorary Medical Officer, Department of Medicine, Dhaka Medical College Hospital, Dhaka
  • Rifat Hossain Ratul Honorary Medical Officer, Department of Medicine, Dhaka Medical College Hospital, Dhaka
  • Motlabur Rahman Associate Professor, Department of Medicine, Dhaka Medical College, Dhaka
  • Mohammad Zaid Hossain Associate Professor, Department of Medicine, Dhaka Medical College, Dhaka
  • Ponkaj Kanti Datta Assistant Professor, Department of Medicine, Dhaka Medical College, Dhaka
  • Md Mohiuddin Sharif Indoor Medical Officer, Department of Medicine, Dhaka Medical College Hospital, Dhaka
  • Khan Abul Kalam Azad Principal and Professor of Medicine, Dhaka Medical College, Dhaka

DOI:

https://doi.org/10.3329/jdmc.v29i2.51187

Keywords:

Potassium, Electrolyte imbalance, Corona, SARS-CoV-2, COVID-19, Dhaka, Bangladesh

Abstract

Importance: Hypokalemia is a neglected common manifestation in COVID-19 patients admitted in hospital though it has serious consequences. Coronavirus may cause hypokalemia through disruptions of rennin-angiotensin system, gastrointestinal loss or other unknown mechanisms.

Objective: To investigate the prevalence of hypokalemia among patients with moderate to severe COVID-19 and its association with other clinical and laboratory parameters.

Design, Setting, and Participants: This was cross sectional observational study conducted at Dhaka medical College Hospital of Bangladesh from June, 2020, to August 2020. Participants were included who were positive for rt-PCR for COVID-19 according to the national guideline. The patients were classified as having severe hypokalemia (plasma potassium <3 mmol/L), hypokalemia (plasma potassium 3-3.5 mmol/L), and normokalemia (plasma potassium >3.5 mmol/L).

Results: Prevalence of hypokalemia among patients with COVID-19 was 20.2%, severe hypokalemia (2 patients [1.5%]) and hypokalemia (25 patients [18.7%]). One thirty four (134) patients with positive COVID-19 were included. The mean [SD] age of these 134 patients according to different potassium levels appear to be : 68 [2.83] years for severe hypokalemia , 51.93[11.68] years for hypokalemia and 50.73[14.7] years for normokalemia. Among them, 46 patients were females [34.32%]) and rest were males [65.68%]. Within the total sum of 134 patients, 107 were identified having normokalemia, [79.9%]. 25 patients [18. 7%] had hypokalemia and only two patients [1.5%] were found having normokalemia. Among 134 patients, three commonest symptoms were fever (132 patients [98.5%]), dry cough (123 patients (91.79%) and shortness of breath (122 patients [91.04%]), followed by less common symptoms like fatigue (89 patients [66.410%]), sore throat (60 patients [44.77%]), and diarrhea (44 patients, [32.83%]). Shortness of breath was associated with grades of hypokalemia (P=0.022). Only 26 patients (19.4%) manifested having vomiting/Nausea. The predominant comorbidities found among these 134 participants were Hypertension (68 patients [64.2%]), Diabetes (54 patients [52.9%]), Ischemic heart disease (37 patients [38.1%]) and Asthma (27 patients [31.0%]). The prevalence of comorbidities was not associated with Hypokalemia.

Conclusions Prevalence of hypokalemia among patients with COVID-19 is high (20.2%) and appropriate treatment is highly required.

J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 131-137

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Published

2021-01-05

How to Cite

Islam, M. K., Hasan, P., Hossain, M. M., Hossain, F. S., Khan, T. D., Ratul, R. H., Rahman, M., Hossain, M. Z., Datta, P. K., Sharif, M. M., & Azad, K. A. K. (2021). Prevalence of hypokalemia in COVID-19 and its association with clinical and common laboratory parameters. Journal of Dhaka Medical College, 29(2), 131–137. https://doi.org/10.3329/jdmc.v29i2.51187

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Original Articles