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1.
Iran J Kidney Dis ; 16(4): 228-237, 2022 07.
Article in English | MEDLINE | ID: covidwho-2073693

ABSTRACT

INTRODUCTION: As a multisystem illness, Coronavirus disease 2019 (COVID-19) can damage different organs. This study investigated the effect of electrolyte imbalance (EI), with or without concomitant renal dysfunction, on the prognosis of COVID-19 in hospitalized patients. METHODS: We evaluated 499 hospitalized patients with confirmed COVID-19, without a history of chronic kidney disease. The patients' demographic data, laboratory values, and outcomes were retrospectively collected from the hospital information system. Serumelectrolytes including sodium, potassium, magnesium, calcium, and phosphorus abnormalities were analyzed on admission and during the hospitalization period. The outcomes of this study were the occurrence of acute kidney injury (AKI) after the first week of hospitalization and in-hospital mortality rate. Multivariate analyses were carried out to obtain the independent risk of each EI on mortality, by adjusting for age, gender, and AKI occurrence. RESULTS: Among the 499 COVID-19 patients (60.9% male), AKI occurred in 168 (33.7%) and mortality in 92 (18.4%) cases. Hypocalcemia (38%) and hyponatremia (22.6%) were the most prevalent EIs, and all EIs were more common in the AKI group than in the non-AKI group. Hyponatremia (Adjusted Odds ratio [AOR] = 2.34, 95% CI: 1.30 to 4.18), hypernatremia (AOR = 8.52, 95% CI: 1.95 to 37.32), and hyperkalemia (AOR = 4.63, 95% CI: 1.65 to 13) on admission were associated with poor prognosis. Moreover, hyponatremia (AOR = 3.02, 95% CI: 1.28 to 7.15) and hyperphosphatemia (AOR = 5.12, 95% CI: 1.24 to 21.09) on admission were associated with late AKI occurrence. CONCLUSION: This study highlights the role of hyponatremia, hypernatremia, hyperkalemia, and hyperphosphatemia in poor prognosis of COVID-19. According to the independent effect of EI on late AKI and mortality, we recommend physicians to raise awareness to closely monitor and correct EI during hospitalization.  DOI: 10.52547/ijkd.6904.


Subject(s)
Acute Kidney Injury , COVID-19 , Hyperkalemia , Hypernatremia , Hyperphosphatemia , Hyponatremia , Water-Electrolyte Imbalance , Acute Kidney Injury/epidemiology , COVID-19/complications , Electrolytes , Female , Hospital Mortality , Humans , Hypernatremia/complications , Male , Retrospective Studies , Risk Factors
2.
Ann Clin Lab Sci ; 52(5): 831-837, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2073089

ABSTRACT

Tuberculosis (TB) and SARS-CoV-2 (COVID-19) are two important infectious diseases causing morbidity and mortality worldwide. Active TB infection can stimulate host immune responses and together with COVID-19, may lead to cytokine storm and immune dysregulation leading to multi-organ failure. We present a rare case of both miliary tuberculosis and SARS-CoV-2 co-infection in an infant who was a 6-month-old previously healthy term boy. He had persistent cough and congestion, became severely ill, and was brought to the emergency department. He was found to be COVID-19 positive by PCR test. Laboratory studies showed pancytopenia, elevated inflammatory markers, and an abnormal coagulation profile with coagulopathy. He developed strokes, severe sepsis, and electrolyte abnormalities, and declined rapidly within 6 days. Autopsy examination showed multifocal micro-abscesses in multiple organs, which on microscopic examination showed necrotic foci teeming with Mycobacteria and were culture positive for M. tuberculosis Neuropathological examination showed infarction in the right middle and posterior cerebral artery territories. This patient helps illuminate some immunological and pathological aspects of two co-occurring infectious diseases and the susceptibility for the development of fatal complications with SARS-CoV-2 infection in the pediatric population.


Subject(s)
COVID-19 , Mycobacterium tuberculosis , Tuberculosis, Miliary , Child , Male , Humans , Infant , Tuberculosis, Miliary/complications , Tuberculosis, Miliary/diagnosis , Tuberculosis, Miliary/pathology , COVID-19/complications , SARS-CoV-2 , Electrolytes
3.
J Prev Med Public Health ; 55(5): 455-463, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2066726

ABSTRACT

OBJECTIVES: Economic hardship has a serious impact on adolescents' mental health. The financial impact of the coronavirus disease 2019 (COVID-19) pandemic was more severe for low-income families, and this also impacted adolescents. This study aimed to examine the associations of economic deterioration (ED) caused by the COVID-19 pandemic and low socioeconomic status (SES) with adolescents' suicidal behaviors. METHODS: This study analyzed data from the 2020 Korea Youth Risk Behavior Web-based Survey, which included 54 948 middle and high school students. Odds ratios (ORs) of suicidal ideation, suicidal planning, and suicide attempts related to ED and SES were calculated using multivariable logistic regression. We calculated relative excess risks due to interaction to assess additive interactions. RESULTS: The ORs for suicidal ideation, suicidal planning, and suicide attempts related to combined severe ED and low SES were 3.64 (95% confidence interval [CI], 3.13 to 4.23), 3.88 (95% CI, 3.09 to 4.88), and 4.27 (95% CI, 3.21 to 5.69), respectively. CONCLUSIONS: ED and low SES were significantly associated with suicidal behaviors in adolescents. Although no significant additive interaction was found, the ORs related to suicidal ideation, suicidal planning, and suicide attempts were highest among adolescents from low-income families with severe ED. Special attention is needed for this group, considering the increased impact of economic inequality due to the COVID-19 pandemic.


Subject(s)
Adolescent Behavior , COVID-19 , Adolescent , Cross-Sectional Studies , Electrolytes , Humans , Internet , Pandemics , Republic of Korea/epidemiology , Risk Factors , Risk-Taking , Social Class , Suicidal Ideation
4.
Molecules ; 27(19)2022 Sep 29.
Article in English | MEDLINE | ID: covidwho-2066280

ABSTRACT

The fast and reliable analysis of electrolytes such as K, Na, Ca in human blood serum has become an indispensable tool for diagnosing and preventing diseases. Laser-induced breakdown spectroscopy (LIBS) has been demonstrated as a powerful analytical technique on elements. To apply LIBS to the quantitative analysis of electrolyte elements in real time, a self-developed portable laser was used to measure blood serum samples supported by glass slides and filter paper in this work. The partial least squares regression (PLSR) method was employed for predicting the concentrations of K, Na, Ca from serum LIBS spectra. Great prediction accuracies with excellent linearity were obtained for the serum samples, both on glass slides and filter paper. For blood serum on glass slides, the prediction accuracies for K, Na, Ca were 1.45%, 0.61% and 3.80%. Moreover, for blood serum on filter paper, the corresponding prediction accuracies were 7.47%, 1.56% and 0.52%. The results show that LIBS using a portable laser with the assistance of PLSR can be used for accurate quantitative analysis of elements in blood serum in real time. This work reveals that the handheld LIBS instruments will be an excellent tool for real-time clinical practice.


Subject(s)
Lasers , Serum , Electrolytes , Humans , Least-Squares Analysis , Spectrum Analysis/methods
5.
Sci Rep ; 12(1): 14732, 2022 08 30.
Article in English | MEDLINE | ID: covidwho-2016845

ABSTRACT

Coronavirus disease 2019 (COVID-19) can be fatal in severe cases. Accordingly, predicting the severity and prognosis of the disease is valuable. This study examined the role of electrolyte imbalances in predicting the severity of COVID-19. In this cross-sectional study, 169 hospitalized patients with COVID-19 were included and categorized into three groups based on the severity of the disease (moderate, severe, and critical). Serum levels of electrolytes (calcium [Ca], phosphorus [P], sodium [Na], potassium [k], and magnesium [Mg]), inflammatory markers (D-dimer, C-reactive protein [CRP], ferritin, and lactate dehydrogenase [LDH]), and 25OHVitamin D were measured. The mean age of patients was 53 years, and 54% were male. They had moderate, severe, and critical illnesses in 22%, 47%, and 31%, respectively. CRP, D-dimer, and ferritin increased with the severity of the disease. The lower median values of Mg, Na, 25OHVitamin D, Ca, LDH, and higher median lymphocyte counts were observed in the moderate vs. the severe group (P < 0.05). These parameters have acceptable sensitivity and specificity at the suggested cut-off level to discriminate the moderate and critical cases. Serum parameters introduced in this study are appropriate for differentiating between critical and moderate cases. The electrolyte imbalance can predict critical patients.


Subject(s)
COVID-19 , C-Reactive Protein/metabolism , COVID-19/diagnosis , Cross-Sectional Studies , Electrolytes/metabolism , Female , Ferritins , Humans , L-Lactate Dehydrogenase/metabolism , Male , Middle Aged , SARS-CoV-2
6.
Medicine (Baltimore) ; 101(32): e30061, 2022 Aug 12.
Article in English | MEDLINE | ID: covidwho-1992409

ABSTRACT

A novel rapid spreading and changing virus called SARS-CoV-2 appeared in Wuhan city in December 2019. It was announced by the World Health Organization (WHO) as a pandemic disease in March 2020. It commonly presents with respiratory symptoms; however, it may be asymptomatic. Electrolyte abnormalities are not uncommon features of SARS-CoV-2 infection. Hyponatremia is one of these electrolyte disturbances among SARS-CoV-2 patients, and it may produce symptoms such as weakness and seizure as the initial presenting symptoms. The underlying mechanism(s) of hyponatremia due to SARS-CoV-2 infection is (are) not established. The aim of this review is to evaluate the possible mechanism of hyponatremia in patients with COVID-19. Understanding and categorizing the hyponatremia in these patients will lead to better treatment and correction of the hyponatremia. A review of the literature between December 2019 and March 2022 was conducted searching for the possible reported mechanism(s) of hyponatremia in SARS-CoV-2. Although SIADH is the commonly reported cause of hyponatremia in SARS-CoV-2 infection, other causes such as diarrhea, vomiting, and kidney salt loss must be considered before SIADH.


Subject(s)
COVID-19 , Hyponatremia , Inappropriate ADH Syndrome , COVID-19/complications , Electrolytes , Humans , Hyponatremia/etiology , Inappropriate ADH Syndrome/etiology , SARS-CoV-2
7.
Iran J Kidney Dis ; 16(4): 228-237, 2022 07.
Article in English | MEDLINE | ID: covidwho-1989996

ABSTRACT

INTRODUCTION: As a multisystem illness, Coronavirus disease 2019 (COVID-19) can damage different organs. This study investigated the effect of electrolyte imbalance (EI), with or without concomitant renal dysfunction, on the prognosis of COVID-19 in hospitalized patients. METHODS: We evaluated 499 hospitalized patients with confirmed COVID-19, without a history of chronic kidney disease. The patients' demographic data, laboratory values, and outcomes were retrospectively collected from the hospital information system. Serumelectrolytes including sodium, potassium, magnesium, calcium, and phosphorus abnormalities were analyzed on admission and during the hospitalization period. The outcomes of this study were the occurrence of acute kidney injury (AKI) after the first week of hospitalization and in-hospital mortality rate. Multivariate analyses were carried out to obtain the independent risk of each EI on mortality, by adjusting for age, gender, and AKI occurrence. RESULTS: Among the 499 COVID-19 patients (60.9% male), AKI occurred in 168 (33.7%) and mortality in 92 (18.4%) cases. Hypocalcemia (38%) and hyponatremia (22.6%) were the most prevalent EIs, and all EIs were more common in the AKI group than in the non-AKI group. Hyponatremia (Adjusted Odds ratio [AOR] = 2.34, 95% CI: 1.30 to 4.18), hypernatremia (AOR = 8.52, 95% CI: 1.95 to 37.32), and hyperkalemia (AOR = 4.63, 95% CI: 1.65 to 13) on admission were associated with poor prognosis. Moreover, hyponatremia (AOR = 3.02, 95% CI: 1.28 to 7.15) and hyperphosphatemia (AOR = 5.12, 95% CI: 1.24 to 21.09) on admission were associated with late AKI occurrence. CONCLUSION: This study highlights the role of hyponatremia, hypernatremia, hyperkalemia, and hyperphosphatemia in poor prognosis of COVID-19. According to the independent effect of EI on late AKI and mortality, we recommend physicians to raise awareness to closely monitor and correct EI during hospitalization.  DOI: 10.52547/ijkd.6904.


Subject(s)
Acute Kidney Injury , COVID-19 , Hyperkalemia , Hypernatremia , Hyperphosphatemia , Hyponatremia , Water-Electrolyte Imbalance , Acute Kidney Injury/epidemiology , COVID-19/complications , Electrolytes , Female , Hospital Mortality , Humans , Hypernatremia/complications , Male , Retrospective Studies , Risk Factors
8.
Kidney Blood Press Res ; 47(9): 556-564, 2022.
Article in English | MEDLINE | ID: covidwho-1950524

ABSTRACT

BACKGROUND: Gitelman's and Bartter's syndromes (GS/BS) are rare genetic tubulopathies characterized by electrolyte imbalance and activation of the renin-angiotensin-aldosterone system (RAAS). These syndromes have intriguing biochemical and hormonal abnormalities that lead them to be protected from hypertension and cardiovascular and renal remodeling. SUMMARY: In this review, we explore the biochemical/molecular mechanisms induced by the activation of the RAAS and its counterregulatory arm which is particularly activated in GS/BS patients, in the context of blood pressure regulation. In addition, we report our findings in the context of the COVID-19 pandemic where we observed GS/BS subjects being protected from infection. KEY MESSAGES: The intracellular pathways induced by Ang II, starting from induction of oxidative stress and vasoconstriction, are crucial for the progression toward cardiovascular-renal remodeling and might be useful targets in order to reduce/halt the progression of Ang II/oxidative stress-induced cardiovascular-renal morbidity in several diseases.


Subject(s)
Bartter Syndrome , COVID-19 , Gitelman Syndrome , Hypertension , Bartter Syndrome/genetics , Bartter Syndrome/metabolism , Electrolytes , Gitelman Syndrome/genetics , Gitelman Syndrome/metabolism , Humans , Hypertension/genetics , Pandemics
9.
Cancer Invest ; 40(9): 743-749, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-1937551

ABSTRACT

We conducted a cross-sectional analysis of ClinicalTrials.gov-registered oncology randomized controlled trials between September 2019 and December 2021 to identify predictors of trial suspensions. The dataset included 1,183 oncology trials, of which 384 (32.5%) were suspended. COVID-19 accounted for 47 (12.2%) suspensions. Trials that were single center- or US-based had higher odds of COVID-19 (ORs: 3.85 and 2.48, 95% CIs: 1.60-11.50 and 1.28-4.93, respectively) or any-reason suspensions (ORs: 2.33 and 2.04, 95% CIs: 1.46-3.45 and 1.40-2.76, respectively). Phase two (OR 1.27), three (OR 6.45) and four trials (OR 11.5) had increased odds of COVID-19 suspensions, compared to phase one trials.


Subject(s)
COVID-19 , Neoplasms , COVID-19/epidemiology , Cross-Sectional Studies , Electrolytes , Humans , Neoplasms/epidemiology , Neoplasms/therapy , Pandemics , Randomized Controlled Trials as Topic , SARS-CoV-2 , Suspensions
10.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 34(5): 502-508, 2022 May.
Article in Chinese | MEDLINE | ID: covidwho-1903520

ABSTRACT

OBJECTIVE: To analyze the relationship between blood electrolytes and the prognosis of patients with severe coronavirus disease 2019 (COVID-19) and to provide assistance for clinical decision-making. METHODS: The clinical data of patients with severe COVID-19 admitted to intensive care unit (ICU) of the Wuhan Third Hospital by the Shanghai aid-Hubei medical team from January 21 to March 4, 2020 were collected. Excluding ineligible patients, 110 patients were finally enrolled. The patients' gender, age, temperature, heart rate, systolic and diastolic blood pressure, clinical symptoms at admission, time of symptom onset, duration of fever, and relevant indicators at admission to ICU (including blood potassium, chloride, sodium, calcium, phosphorus, and magnesium, etc.) and prognosis were analyzed. The patients were grouped by blood potassium or calcium levels or blood potassium/calcium ratio. The Kaplan-Meier survival curves were used to analyze the survival of patients in each group. The relationship between the potassium/calcium ratio and the prognosis was analyzed using restricted cubic spline plots. The relationship between each index in the different models and the prognosis was analyzed using Cox regression models. RESULTS: Among 110 severe COVID-19 patients, 78 cases survived, and 32 cases died. Compared with the surviving group, patients in the death group had higher blood potassium levels [mmol/L: 4.25 (3.80, 4.65) vs. 3.90 (3.60, 4.20), P < 0.05] and lower blood calcium levels (mmol/L: 2.00±0.14 vs. 2.19±0.18, P < 0.05). The Kaplan-Meier survival curves showed that patients in the potassium > 4.2 mmol/L group had a worse prognosis than the potassium < 3.8 mmol/L group and the potassium 3.8-4.2 mmol/L group (P = 0.011), patients in the calcium > 2.23 mmol/L group had a better prognosis than the calcium < 2.03 mmol/L group and the calcium 2.03-2.23 mmol/L group, and the lower calcium group had a worse prognosis (P = 0.000 15). Cox regression analysis showed that the hazard ratio (HR) of blood potassium and calcium were 2.08 and 0.01, respectively, in model 1 (single blood potassium or calcium) and in model 2 (model 1 plus age and gender), the HR of blood potassium and calcium were 1.98 and 0.01 respectively, which were significantly associated with patient prognosis (all P < 0.05). Patients in the group with the potassium/calcium ratio > 1.9 had higher blood potassium levels and a higher proportion of mechanical ventilation, lower calcium levels and lower proportion of survival, and longer time of ICU admission compared with the groups with the potassium/calcium ratio < 1.7 and 1.7-1.9. The Kaplan-Meier survival curves showed that the survival rate of the potassium/calcium ratio > 1.9 group was the lowest (P < 0.000 1), and there was no statistically significant difference in survival between the potassium/calcium ratio < 1.7 group and the potassium/calcium ratio 1.7-1.9 group. A restricted cubic spline plot corrected for age and gender showed that patients in the potassium/calcium ratio > 1.8 group had HR values > 1. Cox regression analysis corrected for other indicators showed that the potassium/calcium ratio was still associated with patient prognosis (HR = 4.85, P = 0.033). CONCLUSION: Blood potassium, calcium, and the potassium/calcium ratio at ICU admission are related to the prognosis of patients with severe COVID-19, and the potassium/calcium ratio is an independent risk factor for the death of patients. The higher the potassium/calcium ratio, the worse the prognosis of patients.


Subject(s)
COVID-19 , Sepsis , Calcium , China , Electrolytes , Humans , Potassium , Prognosis , Retrospective Studies
11.
J Trauma Stress ; 35(5): 1460-1471, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-1898909

ABSTRACT

This study examined posttraumatic stress disorder (PTSD), complex PTSD, depression, and anxiety among U.K. rail workers. A cross-sectional survey examining exposure to seven psychosocial hazards (bullying/harassment; verbal abuse; physical and sexual assault; and hearing about, seeing the aftermath of, or witnessing a fatality), working conditions, physical health, and the impact of COVID-19 was administered to 3,912 participants. Outcome measures were the ITQ, PHQ-9, and GAD-7. Among trauma-exposed participants, 24.3% met the criteria for PTSD or CPTSD; 38.6% and 29.2% of all participants scored in the moderate-to-severe range on the PHQ-9 and GAD-7, respectively. Data were analyzed using logistic and linear regression. Bullying/harassment was positively associated with GAD-7 scores, f2 = .001, and PTSD and CPTSD, ORs = 1.83-2.02. Hearing about and witnessing a fatality were associated with PTSD and CPTSD, ORs = 1.77-2.10. Poorer ergonomics at work were positively associated with PHQ-9 and GAD-7 scores, f2 = .001. Higher job satisfaction was associated with lower odds of PTSD and CPTSD, ORs = 0.87-0.91, and negatively associated with PHQ-9 and GAD-7 scores, f2 = .008-.01. Work intensity was associated with PTSD and CPTSD, ORs = 1.79-1.83, and positively associated with PHQ-9 and GAD-7 scores, f2 = .02-.03. Reporting more physical health problems was associated with PTSD, OR = 1.07, and positively associated with GAD-7 and PHQ-9 scores, f2 = .008-.01. The results suggest bullying/harassment and work intensity are important variables in employee mental health and could drive future research and industry initiatives.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Anxiety/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Electrolytes , Humans , International Classification of Diseases , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology
12.
Ren Fail ; 43(1): 830-839, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1882852

ABSTRACT

Loop diuretics are among the most widely used drugs worldwide and are commonly employed in the management of complications associated with acute kidney injury (AKI), namely volume overload and electrolyte management. The use of loop diuretics in critically ill patients with AKI is paramount to preventing or treating pulmonary edema. The naturetic response to a loop diuretic is based on its unique renal pharmacology. Our review article summarizes the pharmacology of furosemide in the intact nephron and discusses how this response might be altered by the presence of AKI. We discuss the increasing body of literature on the latest clinical utility of furosemide namely, it's challenge test, known as the furosemide stress test which has highlighted a new and novel role for furosemide over the past number of years. This test assists with the identification of AKI subjects at higher risk of AKI progression and the need for renal replacement therapy. The stress test can also predict cessation of continuous renal replacement therapy in patients with established AKI. On the basis of the evidence presented in this review, we propose future potential studies of furosemide in AKI.


Subject(s)
Acute Kidney Injury/diagnosis , Furosemide , Critical Illness , Diuretics , Electrolytes , Exercise Test , Humans , Randomized Controlled Trials as Topic
13.
J Trace Elem Med Biol ; 73: 127015, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1867436

ABSTRACT

OBJECTIVE: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), a worldwide health problem, is the cause of 2019 coronavirus disease. This study aimed to compare the trace element (selenium and iron), electrolyte (calcium and sodium), and physical activity levels of COVID-19 patients before and after COVID-19 treatment. METHOD: This prospective study was conducted in patients diagnosed with COVID-19 (n = 15). Trace element (selenium and iron), electrolyte (calcium and sodium), and physical activity levels of the patients were compared before and after the treatment. RESULT: Most of patients had selenium deficiency (86.7 %), iron deficiency (73.3 %), calcium deficiency (66.7 %) and sodium deficiency (46.7 %) before COVID-19 treatment. The most important improvements were seen in iron deficiency (from 73.3 % to 26.7 %) and sodium deficiency (from 46.7 % to 13.3 %) after the treatment. Selenium, iron, calcium, and sodium levels of the patients were significantly higher after the treatment (p < 0.05). The patients had low physical activity before and after COVID-19 treatment. In addition, no statistically significant difference was found in the comparison of physical activity levels (p > 0.05). CONCLUSION: This study indicated that selenium, iron, calcium, and sodium levels and deficiencies might improve after treating patients with COVID-19. However, the results of this study showed that the physical activity levels of COVID-19 patients might remain stable and low throughout the treatment process.


Subject(s)
COVID-19 , Selenium , Trace Elements , COVID-19/drug therapy , Calcium , Electrolytes , Exercise , Humans , Ions , Iron , Prospective Studies , SARS-CoV-2 , Selenium/therapeutic use , Sodium , Trace Elements/therapeutic use
15.
Top Companion Anim Med ; 46: 100597, 2022.
Article in English | MEDLINE | ID: covidwho-1629279

ABSTRACT

Inflammatory bowel diseases (IBD) in humans are associated with electrolyte shifts and diarrhea. Chronic inflammatory enteropathies (CIE) in dogs produce inflammatory lesions usually located more diffusely throughout the gastrointestinal tract. The prevalence of electrolyte imbalances in canine CIE is unknown. We retrospectively evaluated serum electrolyte (Na+, Cl-, corrected Cl-, and K+) concentrations in 37 dogs with CIE. Hypokalemia was the most frequent electrolyte abnormality, affecting 7 (19%) CIE dogs and with no difference between food-responsive and immunosuppressant-responsive (IRE) cases. Hyponatremia was less common (14%) and predominantly seen with IRE; serum Na+ concentration correlated with the severity of diarrhea and duodenal histologic lesions. Hypo- (5%) and hyperchloridemia (11%) were also detected. Electrolyte imbalances occur with equal frequency in canine CIE and human IBD. Increased K+ secretion might exceed compromised Na+/Cl- absorption or K+ shifts might be more pronounced in canine CIE. Therefore, the mechanisms underlying CIE-associated diarrhea warrant further research.


Subject(s)
Dog Diseases , Inflammatory Bowel Diseases , Animals , Diarrhea/veterinary , Dogs , Electrolytes , Inflammatory Bowel Diseases/complications , Inflammatory Bowel Diseases/veterinary , Retrospective Studies
16.
Int J Clin Pract ; 75(12): e14882, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1555909

ABSTRACT

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.


Subject(s)
COVID-19 , SARS-CoV-2 , Cross-Sectional Studies , Electrolytes , Female , Humans , Male , Sex Characteristics
17.
Physiol Rep ; 9(21): e15061, 2021 11.
Article in English | MEDLINE | ID: covidwho-1513250

ABSTRACT

Angiotensin-converting enzyme 2 (ACE2) and transmembrane proteases (TMPRSS) are multifunctional proteins required for SARS-CoV-2 infection or for amino acid (AA) transport, and are abundantly expressed in mammalian small intestine, but the identity of the intestinal cell type(s) and sites of expression are unclear. Here we determined expression of SARS-CoV-2 entry factors in different cell types and then compared it to that of representative AA, electrolyte, and mineral transporters. We tested the hypothesis that SARS-CoV-2, AA, electrolyte, and mineral transporters are expressed heterogeneously in different intestinal cell types by making mouse enteroids enriched in enterocytes (ENT), goblet (GOB), Paneth (PAN), or stem (ISC) cells. Interestingly, the expression of ACE2 was apical and modestly greater in ENT, the same pattern observed for its associated AA transporters B0 AT1 and SIT1. TMPRSS2 and TMPRSS4 were more highly expressed in crypt-residing ISC. Expression of electrolyte transporters was dramatically heterogeneous. DRA, NBCe1, and NHE3 were greatest in ENT, while those of CFTR and NKCC1 that play important roles in secretory diarrhea, were mainly expressed in ISC and PAN that also displayed immunohistochemically abundant basolateral NKCC1. Intestinal iron transporters were generally expressed higher in ENT and GOB, while calcium transporters were expressed mainly in PAN. Heterogeneous expression of its entry factors suggests that the ability of SARS-CoV-2 to infect the intestine may vary with cell type. Parallel cell-type expression patterns of ACE2 with B0 AT1 and SIT1 provides further evidence of ACE2's multifunctional properties and importance in AA absorption.


Subject(s)
COVID-19/virology , Electrolytes/metabolism , Epithelial Cells/metabolism , Intestines/physiology , Membrane Transport Proteins/metabolism , Minerals/metabolism , SARS-CoV-2/metabolism , Angiotensin-Converting Enzyme 2/metabolism , Animals , COVID-19/metabolism , COVID-19/pathology , COVID-19/transmission , Epithelial Cells/cytology , Epithelial Cells/virology , Immunohistochemistry , Intestines/cytology , Intestines/virology , Male , Membrane Proteins/metabolism , Mice , SARS-CoV-2/isolation & purification , Serine Endopeptidases/metabolism
18.
J Investig Med ; 70(2): 409-414, 2022 02.
Article in English | MEDLINE | ID: covidwho-1440834

ABSTRACT

Early studies have reported various electrolyte abnormalities at admission in patients with severe COVID-19. 104 out of 193 patients admitted to our institution presented with hypermagnesemia at presentation. It is believed this may be important in the evaluation of severe SARS-CoV-2 infections. This study evaluated the outcomes of hypermagnesemia in patients with COVID-19. A retrospective chart review of patients admitted to the hospital with confirmed SARS-CoV-2 infection was conducted. A review of the medical literature regarding hypermagnesemia, magnesium levels in critical care illness and electrolyte abnormalities in patients with COVID-19 was performed. Differences in demographic and clinical characteristics of patients with hypermagnesemia and normomagnesemia were evaluated using descriptive statistics. Other known variables of disease severity were analyzed. 104 patients (54%) were identified with hypermagnesemia (≥2.5 mg/dL). 48 of those patients were admitted to the intensive care unit (46%, p<0.001). 34 patients required ventilator support (32%, p<0.0001). With age-adjusted logistic regression analysis hypermagnesemia was associated with mortality (p=0.007). This study demonstrates that hypermagnesemia is a significant marker of disease severity and adverse outcome in SARS-CoV-2 infections. We recommend serum magnesium be added to the panel of tests routinely ordered in evaluation of severe SARS-CoV-2 infections.


Subject(s)
COVID-19 , Magnesium/blood , COVID-19/blood , Critical Illness , Electrolytes/blood , Humans , Retrospective Studies
19.
Nutrients ; 13(9)2021 Aug 25.
Article in English | MEDLINE | ID: covidwho-1394978

ABSTRACT

The beverage hydration index (BHI) facilitates a comparison of relative hydration properties of beverages using water as the standard. The additive effects of electrolytes, carbohydrate, and protein on rehydration were assessed using BHI. Nineteen healthy young adults completed four test sessions in randomized order: deionized water (W), electrolytes only (E), carbohydrate-electrolytes (C + E), and 2 g/L dipeptide (alanyl-glutamine)-electrolytes (AG + E). One liter of beverage was consumed, after which urine and body mass were obtained every 60 min through 240 min. Compared to W, BHI was higher (p = 0.007) for C + E (1.15 ± 0.17) after 120 min and for AG + E (p = 0.021) at 240 min (1.15 ± 0.20). BHI did not differ (p > 0.05) among E, C + E, or AG + E; however, E contributed the greatest absolute net effect (>12%) on BHI relative to W. Net fluid balance was lower for W (p = 0.048) compared to C + E and AG + E after 120 min. AG + E and E elicited higher (p < 0.001) overall urine osmolality vs. W. W also elicited greater reports of stomach bloating (p = 0.02) compared to AG + E and C + E. The addition of electrolytes alone (in the range of sports drinks) did not consistently improve BHI versus water; however, the combination with carbohydrate or dipeptides increased fluid retention, although this occurred earlier for the sports drink than the dipeptide beverage. Electrolyte content appears to make the largest contribution in hydration properties of beverages for young adults when consumed at rest.


Subject(s)
Beverages/analysis , Dehydration/prevention & control , Dietary Carbohydrates/pharmacology , Dietary Proteins/pharmacology , Electrolytes/pharmacology , Water-Electrolyte Balance/physiology , Adult , Dietary Carbohydrates/urine , Dietary Proteins/urine , Double-Blind Method , Electrolytes/analysis , Electrolytes/urine , Female , Humans , Male , Time Factors , Water/administration & dosage , Young Adult
20.
Adv Healthc Mater ; 10(20): e2100955, 2021 10.
Article in English | MEDLINE | ID: covidwho-1368425

ABSTRACT

An overview of cytokine biosensing is provided, with a focus on the opportunities provided by organic electronic platforms for monitoring these inflammation biomarkers which manifest at ultralow concentration levels in physiopathological conditions. Specifically, two of the field's state-of-the-art technologies-organic electrochemical transistors (OECTs) and electrolyte gated organic field effect transistors (EGOFETs)-and their use in sensing cytokines and other proteins associated with inflammation are a particular focus. The overview will include an introduction to current clinical and "gold standard" quantification techniques and their limitations in terms of cost, time, and required infrastructure. A critical review of recent progress with OECT- and EGOFET-based protein biosensors is presented, alongside a discussion onthe future of these technologies in the years and decades ahead. This is especially timely as the world grapples with limited healthcare diagnostics during the Coronavirus disease (COVID-19)pandemic where one of the worst-case scenarios for patients is the "cytokine storm." Clearly, low-cost point-of-care technologies provided by OECTs and EGOFETs can ease the global burden on healthcare systems and support professionals by providing unprecedented wealth of data that can help to monitor disease progression in real time.


Subject(s)
Biosensing Techniques , COVID-19 , Biomarkers , Electrolytes , Humans , Inflammation/diagnosis , SARS-CoV-2 , Transistors, Electronic
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