The Association of Serum Electrolytes with Disease Severity and Obstetric Complications in Pregnant Women with COVID-19: a Prospective Cohort Study from a Tertiary Reference Center

Abstract

Introduction To evaluate the association of serum electrolytes with disease severity and obstetric complications in pregnant women with Coronavirus disease 2019 (COVID-19).

Materials and Methods This prospective cohort study was conducted on pregnant women with confirmed COVID-19. Study population was divided into two groups: 1) Mild COVID-19 group (n = 811) and 2) Moderate/severe COVID-19 group (n = 52). Demographic features, clinical characteristics, obstetric complications, and serum electrolytes were compared between the groups. Afterward, a correlation analysis was performed to investigate the association between serum electrolyte disturbances with COVID-19 severity and obstetric complications.

Results Highest serum sodium, hypernatremia, potassium replacement, hypopotassemia, hyperchloremia, initial serum magnesium, hypermagnesemia, and hypocalcemia were significantly higher in the moderate/severe COVID-19 group. The lowest serum sodium, lowest serum potassium, and initial serum calcium were significantly higher in the mild COVID-19 group (p < 0.05). Statistically significant positive weak correlations were found between hypernatremia, hypopotassemia, hyperchloremia, hypermagnesemia, hypocalcemia and COVID-19 severity (r values were 0.27, 0.20, 0.12, 0.18 and 0.12, p values were < 0.001, < 0.001, 0.02, 0.03 and 0.03, respectively). Furthermore, statistically significant positive weak correlations were found between hypopotassemia, hypochloremia, hypermagnesemia, and obstetric complications (r values were 0.10, 0.10, and 0.28, p values were 0.004, 0.03, and 0.001, respectively). A statistically significant negative weak correlation was found between hypomagnesemia and obstetric complications (r = − 0.23 and p = 0.01, respectively).

Conclusion Electrolyte disturbances in pregnant women with COVID-19 seem to be associated with disease severity and obstetric complications.

Zusammenfassung

Einleitung Ziel der Studie war es, die Verbindung zwischen dem Schweregrad der Erkrankung und den geburtshilflichen Komplikationen bei schwangeren Frauen, die nach Infektion mit SARS-CoV-2 an COVID-19 erkrankt sind, zu evaluieren.

Material und Methoden Diese prospektive Kohortenstudie wurde in einer Gruppe von schwangeren Frauen mit bestätigter COVID-19-Erkrankung durchgeführt. Die Studienpopulation wurde in 2 Gruppen unterteilt: 1) eine Gruppe bestand aus Frauen mit milder COVID-19-Erkrankung (n = 811) und 2) eine Gruppe bestand aus Frauen mit mittelschwerer/schwerer COVID-19-Erkrankung (n = 52). Die demografischen Merkmale, klinischen Charakteristika, geburtshilflichen Komplikationen und der Elektrolytspiegel beider Gruppen wurden verglichen. Danach wurde eine Korrelationsanalyse durchgeführt, um einen möglichen Zusammenhang zwischen Störungen des Elektrolytspiegels und dem COVID-19-Schweregrad bzw. den geburtshilflichen Komplikationen zu untersuchen.

Ergebnisse Die höchsten Natriumkonzentrationen im Blut, Hypernatriämie, Kaliumsubstitution, Kaliummangel, Hyperchlorämie, die anfänglichen Magnesiumkonzentrationen im Blut, Hypermagnesiämie und Hypokalzämie waren alle signifikant höher in der Gruppe mit mittelschwerer/schwerer COVID-19-Erkrankung. Die tiefsten Natriumkonzentrationen im Blut, tiefsten Kaliumkonzentrationen im Blut und die anfänglichen Kalziumkonzentrationen im Blut waren signifikant höher in der Gruppe mit milder COVID-19-Erkrankung (p < 0,05). Es gab statistisch signifikante schwache positive Korrelationen zwischen Hypernatriämie, Hypokaliämie, Hyperchlorämie, Hypermagnesiämie, Hypokalzämie und dem COVID-19-Schweregrad (der r-Wert betrug jeweils 0,27, 0,20, 0,12, 0,18 und 0,12; der p-Wert betrug jeweils < 0,001, < 0,001, 0,02, 0,03 und 0,03). Es gab auch statistisch signifikante schwache positive Korrelationen zwischen Hypokaliämie, Hyperchlorämie, Hypermagnesiämie und den geburtshilflichen Komplikationen (der r-Wert betrug jeweils 0,10, 0,10 und 0,28; der p-Wert betrug 0,004, 0,03 und 0,001). Eine statistisch signifikante schwache negative Korrelation gab es auch zwischen Hypermagnesiämie und geburtshilflichen Komplikationen (r = − 0,23 und p = 0,01).

Schlussfolgerung Es scheint eine Verbindung zwischen Störungen des Elektrolytspiegels bei schwangeren Frauen, die an COVID-19 erkrankt sind, und dem Schweregrad der Erkrankung bzw. den geburtshilflichen Komplikationen zu geben.

Key words

COVID-19 - disease severity - electrolytes - obstetric complications - pregnancy

Schlüsselwörter

COVID-19 - Schweregrad der Erkrankung - Elektrolyten - geburtshilfliche Komplikationen - Schwangerschaft

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