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Gastrointestinal Symptoms in Association With Hypokalemia Can Be a Predictor of Inferior Outcomes in COVID-19

Nicholas Wong Wai Cheong1, Veeraraghavan Meyyur Aravamudan2, Jonathen Venkatachalam3

  • 1Department of Internal Medicine, Woodlands Health Campus, Singapore, SGP.

Cureus
|May 17, 2021
PubMed

Insights

COVID-19 infection is linked to hypokalemia, a condition of low potassium levels, particularly in migrant workers. This study found a 28.4% prevalence of hypokalemia in hospitalized COVID-19 patients, with gastrointestinal issues being a key factor.

Area of Science:

  • Infectious Diseases
  • Internal Medicine
  • Biochemistry

Background:

  • The COVID-19 pandemic, caused by SARS-CoV-2, has had a global impact.
  • In Singapore, a significant proportion of COVID-19 cases were observed among foreign workers in dormitories.
  • Hypokalemia has been anecdotally reported in COVID-19 patients, but its prevalence and causes require further investigation.

Purpose of the Study:

  • To investigate the association between COVID-19 infection and hypokalemia.
  • To determine the prevalence of hypokalemia among migrant workers hospitalized with COVID-19 in Singapore.
  • To identify potential risk factors contributing to hypokalemia in this population.

Main Methods:

  • A retrospective review of medical records was conducted for migrant workers admitted to a public hospital in Singapore between April 13 and April 26, 2020.
  • Data collected included patient demographics, COVID-19 status, electrolyte levels (specifically potassium), and presence of gastrointestinal symptoms.
  • Statistical analysis was performed to calculate the prevalence of hypokalemia and assess associations with clinical factors.

Main Results:

  • Fifty out of the studied patients had hypokalemia, resulting in a prevalence of 28.4% (95% CI: 21.9-35.7).
  • Gastrointestinal symptoms, including diarrhea, vomiting, and poor oral intake, were present in 5.7% (95% CI: 2.8-10.2) of the study group and identified as a significant cause of hypokalemia.
  • The findings highlight a notable incidence of hypokalemia in COVID-19 patients, particularly those with gastrointestinal manifestations.

Conclusions:

  • Hypokalemia is a significant clinical finding in hospitalized COVID-19 patients, especially among migrant workers.
  • Gastrointestinal losses are a major contributor to hypokalemia in this patient group.
  • Clinicians should consider routine screening for hypokalemia in COVID-19 patients and promptly initiate potassium replacement therapy to prevent complications such as cardiac arrhythmias.

Keywords:
covid 19gastrointestinal losseshypokalemia

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