International Journal of General Medicine (Sep 2021)

Hypophosphatemia at Admission is Associated with Increased Mortality in COVID-19 Patients

  • Wang R,
  • He M,
  • Kang Y

Journal volume & issue
Vol. Volume 14
pp. 5313 – 5322

Abstract

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Ruoran Wang,1,* Min He,1,2,* Yan Kang1,2 1Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, People’s Republic of China; 2COVID19 Medical Team (Hubei) of West China Hospital, Sichuan University, Chengdu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yan KangDepartment of Critical Care Medicine, West China Hospital, No. 37, Guo Xue Xiang, Chengdu, Sichuan Province, People’s Republic of ChinaTel +86 2885422456Fax +86 2885423453Email [email protected]: Electrolyte disturbances are commonly observed in patients with coronavirus disease 2019 (COVID-19) and associated with outcome in these patients. Our study was designed to examine whether hypophosphatemia is associated with mortality in COVID-19 patients.Methods: Patients diagnosed with COVID-19 and hospitalized in Renmin Hospital of Wuhan University between January 30 and February 24, 2020 were included in this study. Patients were divided into two groups, a hypophosphatemia group and a non-hypophosphatemia group, based on a serum phosphate level of 0.8 mmol/L. Logistic regression was performed to analyze the relationship between hypophosphatemia and mortality. A locally weighted scatterplot smoothing (LOWESS) curve was plotted to show the detailed association between mortality rate and serum phosphate level. A Kaplan–Meier survival curve was drawn to compare the difference in cumulative survival between the two groups.Results: Hypophosphatemia at admission occurred in 33 patients, with an incidence of 7.6%. The hypophosphatemia group had a significantly higher incidence of respiratory failure (54.5% vs 32.6%, p=0.013) and mortality (57.6% vs 15.2%, p< 0.001). Multivariate logistic regression indicated that age (OR=1.059, p< 0.001), oxygen saturation (OR=0.733, p< 0.001), white blood cells (OR=1.428, p< 0.001), lymphocytes (OR=0.075, p< 0.001) and hypophosphatemia (OR=3.636, p=0.015) were independently associated with mortality in the included patients. The hypophosphatemia group had significantly shorter survival than the non-hypophosphatemia group (p< 0.001).Conclusion: Hypophosphatemia at admission is associated with increased mortality in COVID-19 patients. More attention and medical care should be given to COVID-19 patients with hypophosphatemia at admission.Keywords: hypophosphatemia, serum phosphate, COVID-19, mortality

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