高氯血症有负面后果,如促炎介质增加,肾功能不全,感染性休克患者的死亡率。然而,关于高氯血症对COVID-19感染影响的数据很少。本研究旨在探讨高氯血症对炎症标志物的影响,血清肌酐,血红蛋白水平,重症COVID-19患者的预后。对2020年1月至2021年8月法赫德国王大学医院ICU收治的所有患有中重度COVID-19感染的成年患者进行了回顾性分析。血清氯化物水平,铁蛋白,乳酸脱氢酶(LDH),C反应蛋白(CRP),肌酐,并在入住ICU的第1天和第3天收集血红蛋白水平.人口统计数据,氧气支持模式,ICU住院时间(ICULOS),肾脏替代疗法(RRT),和死亡被收集。420名患者中,包括255人;97人(38%)患有高氯血症,而158(62%)没有。高血脂症患者的铁蛋白升高比例较高(54.6%),CRP(6.2%),入院第一天和第三天之间的LDH(15.5%),与非高血病患者相比(43.7%,6.3%,5.7%,分别)。两组的血红蛋白水平下降相似(p=0.103)。高氯血症与血清肌酐升高之间存在显著关联(p<0.0001)。高血压组66例(68%)患者需要气管插管(p=0.003)。高血组群的死亡率显著(p=<0.0001)。高氯血症与肾损伤风险增加显著相关,气管插管,和死亡。然而,高氯血症与铁蛋白升高无关,CRP,重症COVID-19患者的血红蛋白下降。
Hyperchloremia has negative consequences, such as increased proinflammatory mediators, renal dysfunction, and mortality in patients with septic shock. However, data on the effects of
hyperchloremia on COVID-19 infections are scarce. The study aimed to investigate the effects of
hyperchloremia on inflammatory markers, serum creatinine, hemoglobin levels, and outcomes in critically ill COVID-19 patients. A retrospective review of all adult patients admitted to the ICU at King Fahd University Hospital with a moderate to severe COVID-19 infection from January 2020 to August 2021 was performed. Serum chloride levels, ferritin, lactate dehydrogenase (LDH), C-reactive protein (CRP), creatinine, and hemoglobin levels were collected on the first and third days of ICU admission. Demographic data, oxygen support modality, ICU length of stay (ICU LOS), renal replacement therapy (RRT), and deaths were collected. Of 420 patients, 255 were included; 97 (38%) had
hyperchloremia, while 158 (62%) did not. Hyperchloremic patients had a higher percentage of increases in ferritin (54.6%), CRP (6.2%), and LDH (15.5%) between the first and third days of admission, compared to non-hyperchloremic patients (43.7%, 6.3%, and 5.7%, respectively). The decrease in hemoglobin levels was similar in both groups (p=0.103). There was a significant association between
hyperchloremia and an increase in serum creatinine (p<0.0001). Sixty-six (68%) patients required endotracheal intubation in the hyperchloremic group (p=0.003). The mortality rate was significant in the hyperchloremic cohort (p=<0.0001). Hyperchloremia was significantly associated with increased risks of kidney injury, endotracheal intubation, and death. However, hyperchloremia was not associated with increased ferritin, CRP, or hemoglobin decreases in critically ill COVID-19 patients.