Related Experiment Video
Updated: Oct 20, 2025
Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
Hypophosphatemia at Admission is Associated with Increased Mortality in COVID-19 Patients
Ruoran Wang1, Min He1,2, Yan Kang1,2
1Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China.
Insights
Hypophosphatemia, a common electrolyte disturbance in COVID-19 patients, significantly increases mortality risk. Early identification and management of low phosphate levels in coronavirus disease 2019 patients are crucial for improving outcomes.
Area of Science:
- Internal Medicine
- Critical Care Medicine
- Infectious Diseases
Background:
- Electrolyte disturbances are frequent in COVID-19 patients.
- These imbalances are linked to patient outcomes.
- The specific association between hypophosphatemia and COVID-19 mortality requires investigation.
Purpose of the Study:
- To determine if hypophosphatemia at hospital admission is associated with increased mortality in COVID-19 patients.
- To analyze the relationship between serum phosphate levels and mortality rates.
Main Methods:
- Retrospective study of hospitalized COVID-19 patients (Jan 30-Feb 24, 2020).
- Patients classified into hypophosphatemia (serum phosphate <0.8 mmol/L) and non-hypophosphatemia groups.
- Logistic regression, LOWESS curves, and Kaplan-Meier survival analysis were employed.
Main Results:
- Hypophosphatemia occurred in 7.6% of patients, with higher rates of respiratory failure (54.5%) and mortality (57.6%).
- Multivariate analysis identified hypophosphatemia as an independent predictor of mortality (OR=3.636, p=0.015).
- The hypophosphatemia group exhibited significantly shorter survival times (p<0.001).
Conclusions:
- Hypophosphatemia at admission is a significant risk factor for mortality in COVID-19 patients.
- Increased clinical attention and medical care are warranted for COVID-19 patients presenting with hypophosphatemia.
Background:
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.
Related Concept Videos
01:24Chronic Kidney Disease II: Clinical Manifestations
01:25Peritoneal Dialysis III: Nursing Management
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:28Chronic Kidney Disease III: Interprofessional Care
01:24Nephrotic Syndrome I : Introduction