Open AccessSex differences in electrolyte imbalances caused by SARS‐CoV‐2: A cross‐sectional study
Author(s) -
Pani Arianna,
Inglese Elvira,
Puoti Massimo,
Cento Valeria,
Alteri Claudia,
Romandini Alessandra,
Di Ruscio Federica,
Senatore Michele,
Moreno Mauro,
Tarsia Paolo,
Colombo Fabrizio,
Epis Oscar Massimiliano,
Panetta Valentina,
Vismara Chiara,
Bellone Andrea,
Scaglione Francesco
Publication year - 2021
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.14882
Subject(s) - medicine , cross sectional study , odds ratio , emergency department , covid-19 , pediatrics , pathology , psychiatry , disease , infectious disease (medical specialty)
Background Since SARS‐CoV‐2 spread, evidence regarding sex differences in progression and prognosis of COVID‐19 have emerged. Besides this, studies on patients' clinical characteristics have described electrolyte imbalances as one of the recurrent features of COVID‐19. Methods We performed a cross‐sectional study on all patients admitted to the emergency department (ED) from 1 March to 31 May 2020 who had undergone a blood gas analysis and a nasopharyngeal swab test for SARS‐CoV‐2 by rtPCR. We defined positive patients as cases (n = 710) and negatives as controls (n = 619), for a total number of patients of 1.329. The study was approved by the local ethics committee Area 3 Milan. Data were automatically extracted from the hospital laboratory SQL‐based repository in anonymised form. We considered as outcomes potassium (K + ), sodium (Na + ), chlorine (Cl − ) and calcium (Ca ++ ) as continuous and as categorical variables, in their relation with age, sex and SARS‐CoV‐2 infection status. Results We observed a higher prevalence of hypokalaemia among patients positive for SARS‐CoV‐2 (13.7% vs 6% of negative subjects). Positive patients had a higher probability to be admitted to the ED with hypokalaemia (OR 2.75, 95% CI 1.8‐4.1, P < .0001) and women were twice as likely to be affected than men (OR 2.43, 95% CI 1.67‐3.54, P < .001). Odds ratios for positive patients to manifest with an alteration in serum Na + was (OR 1.6, 95% CI 1.17‐2.35, P < .001) and serum chlorine (OR 1.6, 95% CI 1.03‐2.69, P < .001). Notably, OR for positive patients to be hypocalcaemic was 7.2 (95% CI 4.8‐10.6, P < .0001) with a low probability for women to be hypocalcaemic (OR 0.63, 95% CI 0.4‐0.8, P = .005). Conclusions SARS‐CoV‐2 infection is associated with a higher prevalence of hypokalaemia, hypocalcaemia, hypochloraemia and sodium alterations. Hypokalaemia is more frequent among women and hypocalcaemia among men.