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Supratherapeutic lithium levels in COVID-19 infection
Danilo Rojas-Velasquez1, Brooke Lifland1, Mario Andres Caro1
1Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
Bipolar Disorders
|February 6, 2022
Summary
Routine lithium level monitoring is crucial for COVID-19 patients. This helps prevent potentially toxic supratherapeutic levels, even when kidney function appears normal.
Area of Science:
- Nephrology
- Infectious Diseases
- Pharmacology
Background:
- Lithium is a common mood stabilizer with a narrow therapeutic index.
- Acute kidney injury (AKI) is a known risk factor for lithium toxicity.
- COVID-19 infection can affect renal function and drug metabolism.
Purpose of the Study:
- To investigate the impact of COVID-19 infection on lithium levels.
- To determine if lithium levels can become supratherapeutic in COVID-19 patients despite normal creatinine.
- To recommend optimal monitoring strategies for lithium in COVID-19 patients.
Main Methods:
- Retrospective chart review of patients on lithium therapy.
- Analysis of lithium levels, creatinine, and COVID-19 status.
- Comparison of lithium levels in patients with and without COVID-19.
Main Results:
- Lithium levels can increase to supratherapeutic ranges during COVID-19 infection.
- This elevation can occur even when serum creatinine levels have normalized.
- Patients with COVID-19 showed a higher incidence of supratherapeutic lithium levels.
Conclusions:
- COVID-19 infection poses a risk for developing supratherapeutic lithium levels.
- Routine monitoring of lithium levels is recommended for all patients with COVID-19.
- This proactive approach is essential to prevent lithium toxicity.
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