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Association of Serum Potassium Variability With 60-day Mortality and Cardiovascular Events after COVID-19 Infection
Moxuan Feng1, Dan Li2, Fengyun Hao3
1Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
Insights
Increased serum potassium variability in maintenance hemodialysis patients post-coronavirus disease 2019 (COVID-19) infection is linked to higher 60-day mortality and cardiovascular disease (CVD) risk.
Area of Science:
- Nephrology
- Infectious Diseases
- Cardiology
Background:
- Maintenance hemodialysis (MHD) patients face heightened risks post-COVID-19 infection.
- Serum potassium levels are critical in MHD patients, and variability may impact outcomes.
Purpose of the Study:
- To investigate the association between serum potassium variability and 60-day mortality and cardiovascular disease (CVD) in MHD patients after COVID-19 infection.
Main Methods:
- Retrospective study of 296 MHD patients infected with COVID-19.
- Kaplan-Meier survival analysis and multivariate Cox/Logistic regression models were used.
- Analysis focused on 60-day mortality and CVD incidence based on potassium variability.
Main Results:
- Higher potassium variability was associated with increased all-cause mortality (P=0.024).
- Adjusted analysis revealed a 2.06-fold increased risk of 60-day mortality (HR=2.06, P=0.040) and a 4.09-fold increased risk of CVD (OR=4.09, P=0.005) in the highest variability group.
Conclusions:
- Increased serum potassium variability post-COVID-19 infection significantly elevates the risk of 60-day mortality and CVD in MHD patients.
- Monitoring and managing potassium variability may be crucial for improving outcomes in this population.
Abstract:
Objective: This study aimed to investigate the association between serum potassium variability and 60-day mortality and cardiovascular disease (CVD) in maintenance hemodialysis (MHD) patients following the coronavirus disease 2019 (COVID-19) infection. Methods: We conducted a retrospective study on MHD patients treated at the affiliated hospital of Qingdao University hemodialysis center who were infected with the novel coronavirus between December 1, 2022, and January 31, 2023. Baseline characteristics of patients were collected from electronic medical records. Kaplan-Meier survival analysis was used to obtain patient survival probabilities, and multivariate Cox hazard regression models and binary Logistic regression models were used to obtain hazard ratios (HR), odds ratios (OR), and 95% confidence intervals (95% CI) between exposure and outcomes. Results: A total of 296 patients were included in this study, with a mean age of 57.2±16.3 years, and 59.8% were male. The 60-day mortality rate was 10.8%, and the incidence of CVD was 32.8%. Kaplan-Meier curves showed that a higher potassium variability coefficient was associated with higher all-cause mortality (P = 0.024). After adjusting for potential confounders, multivariate Cox regression analysis showed that the HR for 60-day mortality in the Q4 group compared to the Q1 group was 2.06 (95% CI = 1.03-4.09, P = 0.040), and binary Logistic regression analysis showed that the OR for 60-day CVD in the Q4 group compared to the Q1 group was 4.09 (95% CI = 1.52-10.97, P = 0.005). Conclusion: Increased serum potassium variability in MHD patients after COVID-19 infection significantly increased the likelihood of 60-day mortality and CVD.
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