SPECTRUM OF BIOCHEMICAL ALTERATIONS IN PATIENTS WITH COVID-19
Background: The COVID-19 pandemic has claimed millions of lives around the globe. In addition to respiratory involvement, multi organ failure has also been noted in these patients. We tried to assess the biochemical abnormalities in these patients to have a better understanding of this disease and its complications. Methods: Adult patients (n=107) who tested positive for COVID-19 by RT-PCR were included in this study. Blood was analysed for Urea, Creatinine, Ferritin, Lactate Dehydrogenase (LDH), Calcium, Magnesium and Phosphorus in Cobas C501 (Roche Diagnostics) using spectrophotometric technology. Sodium, Chloride, Potassium and Bicarbonate were analysed on NOVA electrolyte analyser using ion-selective electrodes. Results: Urea and creatinine were elevated in 33.6% and 22.4% patients respectively. Ferritin and LDH were high in 88.8% and 93.5% patients respectively. Reduced levels of electrolytes was observed , i.e., Sodium in 44.9%, Potassium in 22.4%, Bicarbonate in 53.3%, Calcium in 48.6%, and Phosphorus in 23.4% patients. There were no significant differences in abnormalities in the different age groups (p>0.05). Conclusion: COVID-19 patients suffer from pulmonary disease as well as multi-organ involvement as seen by the biochemical alterations, and this should be kept in mind while treating these patients.
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Alvarez-Belon L, Sarnowski A, Forni LG. COVID-19 infection and the kidney. Br J Hosp Med 2020;81(10).
Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int 2020;97(5):829–38.
Hong XW, Chi ZP, Liu GY, Huang H, Guo SQ, Fan JR, et al. Characteristics of renal function in patients diagnosed with COVID-19: An observational study. Front Med 2020;7:409.
Mabillard H, Sayer JA. Electrolyte disturbances in SARS-CoV-2 Infection. F1000Res. 2020;9:587.
Hu W, Lv X, Li C, Xu Y, Qi Y, Zhang Z, et al. Disorders of sodium balance and its clinical implications in COVID-19 patients: a multicenter retrospective study. Int Emerg Med 2021;16(4):853–62.
Sharma PK, Aggarwal V, Sapariya N, Baweja S, Nagori R, Chabbra MK. Renal profile of COVID-19 infected patients admitted in a tertiary care hospital in Western Rajasthan. Int Surg J 2020;7(7):2332–6
Wang L, Li X, Chen H, Yan S, Li D, Li Y, et al. Coronavirus disease 19 infection does not result in acute kidney injury: An analysis of 116 hospitalized patients from Wuhan, China. Am J Nephrol 2020;51:343–8.
Batlle D, Soler MJ, Sparks MA, Hiremath S, South AM, Welling PA, et al. Acute kidney injury in COVID-19: Emerging evidence of a distinct pathophysiology. J Am Soc Nephrol 2020;31(7):1380–3.
Chen D, Li X, Song Q, Hu C, Su F, Dai J, et al. Assessment of hypokalemia and clinical characteristics in patients with coronavirus disease 2019 in Wenzhou, China. JAMA Network Open 2020;3(6):e2011122.
Hayat A, Majeed N, Abbas S, Akhtar F, Tashfeen S, Siddique A. Renal impairment: Is there a need for monitoring renal functions in COVID infection? Pak Armed Forces Med J 2020;70:S354–7.
Mahmoudi H, Alikhani MY, Taheri NM, Behzadi A. Assessment of changes in blood urea and creatinine levels in patients with coronavirus disease 2019 (COVID-19). https://doi.org/1021203/ rs3rs-25164/v1.
Patel N, Rein JL, Sanchez-Russo L, Winston J, Uribarri J. COVID-19-Associated Acute Kidney Injury: A case series. Kidney Med 2020;2(5):668–9.
Asghar MS, Kazmi SJH, Khan NA, Akram M, Khan SA, Rasheed U, et al. Clinical profiles, characteristics, and outcomes of the first 100 admitted COVID-19 patients in Pakistan: A single-center retrospective study in a tertiary care hospital of Karachi. Cureus 2020;12(6):e8712.
Nakanishi H, Suzuki M, Maeda H, Nakamura Y, Ikegami Y, Takenaka Y, et al. Differential diagnosis of COVID-19: importance of measuring blood lymphocytes, serum electrolytes, and olfactory and taste functions. Tohoku J Exp Med 2020;252(2):109–19.
Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Cham Lab Med 2020;58(7):1021–8.
Oussalah A, Gleye S, Urmes IC, Laugel E, Barbe F, Orlowski S, et al. The spectrum of biochemical alterations associated with organ dysfunction and inflammatory status and their association with disease outcomes in severe COVID-19: A longitudinal cohort and time-series design study. EClinicalMedicine 2020;27:100554.
Ghahramani S, Tabrizi R, Lankarani KB, Kashani SMA, Rezaei S, Zeidi N, et al. Laboratory features of severe vs. non-severe COVID-19 patients in Asian populations: a systematic review and meta-analysis. Eur J Med Res 2020;25(1):30.
Lippi G, South AM, Henry BM. Electrolyte imbalances in patients with severe coronavirus disease 2019 (COVID-19). Ann Clin Biochem 2020;57(3):262–5.
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