Republic of the Philippines

TARLAC STATE UNIVERSITY

COLLEGE OF SCIENCE
DEPARTMENT OF NURSING
Villa Lucinda Campus, Brgy. Ungot, Tarlac City, Philippines 2300
Tel. no.: (045) 4931865 Fax: (045) 982-0110 website: www.tsu.edu.ph

Journal Reading

Source

Lippi, G., South, A., Henry, B. M. (2020). Electrolyte imbalances in patients with severe
coronavirus disease 2019 (COVID-19). International Journal of Laboratory Medicine,
57(3), 262-265.Retrieved from
https://journals.sagepub.com/doi/full/10.1177/0004563220922255

Introduction

Many clinical traits of patients with coronavirus disease 2019 (COVID-19), an emerging
infectious disease brought on by the severe acute respiratory syndrome coronavirus 2, have
been identified. Early COVID-19 investigations have found some indication that electrolyte
issues, such as imbalances in sodium, potassium, chloride, and calcium, may also be present.
According to some theories, persons with more severe forms of COVID-19 exhibit a larger
proportion of baseline hypokalemia than do those with less severe forms of the illness. Such
electrolyte abnormalities have significant effects on patient care as well as the investigation of
putative pathophysiologic processes causing COVID-19, which may lead to new treatment
possibilities. To improve their present understanding of electrolyte imbalance in COVID-19, the
researcher set out to conduct a pooled study comparing sodium, potassium, chloride, and
calcium blood concentration between patients with severe disease and those with less severe
disease.

Procedures

With the terms "sodium" OR "potassium" OR "chloride" OR "calcium" AND "coronavirus

2019" OR "COVID-19" OR "2019-nCoV" OR "SARS-CoV-2" in all fields, from December 1,
2019, through March 23, 2020, a search of Medline (PubMed interface), Scopus, and Web of
Science was conducted. There were no limits on dates or languages. A pooled analysis
includes inform readers the mean or median values for serum electrolytes in laboratory-
confirmed adult COVID-19-positive patients (>18 years of age), with or without severe illness.
Inclusion required a clinically sound definition of "severe disease" in accordance with the New
Coronavirus Infected Pneumonia Diagnosis and Treatment Program published by the National
Health Commission of the People's Republic of China (i.e., patients requiring mechanical
ventilation, vital life support, or admission to an intensive care unit). In laboratory-confirmed
COVID-19 individuals with or without (i.e., versus) severe illness, a pooled analysis was done to
assess the total mean variance with 95% confidence level for each electrolyte (sodium,
potassium, chloride, and calcium). MetaXL, a program that uses an inverse significant change
and is now at version 5.3, was used to do the statistical study.
Finding and Conclusions

According to the pooled data, individuals with severe COVID-19 had considerably lower
salt levels than patients with less severe illness. With far less variation than that shown for
sodium, potassium was similarly significantly lower in COVID-19 individuals with severe illness
compared to those without severe disease. Chloride showed little heterogeneity, and there was
no discernible difference between those who were severe and those who weren't. There was no
evidence of study heterogeneity when calcium concentration was examined between individuals
with severe COVID-19 and those with less severe illness.

In conclusion, their pooled study supports the finding that lower serum sodium,
potassium, and calcium concentrations are related to COVID-19 severity. However, it is
unknown at this time whether COVID-19 is more likely to cause hyponatremia, hypokalemia, or
hypocalcemia, and more clinical data, such as hydration status and serum creatinine and
ionized calcium concentrations, would be required to interpret these abnormalities.

Personal Comments

Based on the study, individuals with severe illnesses or infected with Covid-19 had
significantly lower sodium, potassium, and calcium level. Acquiring Covid-19 which is relevant
nowadays has a severe impact on our fluid and electrolyte content in the body. It could bring
imbalances that could aggravate disease and illnesses. This case was helpful in my current
rotation since the topic/discussion was all about fluid and electrolytes and its imbalances.
Knowing this study can help improve my understanding and it can also broaden my knowledge
so that when I encounter patients with the same condition, I already have an initial background
of it. Furthermore, the result of this study can help give proper interventions and care to patients
so that we can lessen its severity and lengthen their lives as much as possible. We all know that
the Covid-19 is deadly and many individuals all around the world have died because of it. I can
relate this study to my RLE rotation/practicum since we will be going to tackle about
hyponatremia, hypokalemia, and hypocalcemia and vice versa. I hope that when our clinical
instructor discusses about it, I can use my knowledge on this study to understand more about
fluids and electrolyte imbalances.