Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan 1;18(3):736-743.
doi: 10.7150/ijms.50965. eCollection 2021.

Association Between Average Plasma Potassium Levels and 30-day Mortality During Hospitalization in Patients with COVID-19 in Wuhan, China

Shengcong Liu  1   2 , Long Zhang  1   2 , Haoyu Weng  1   2 , Fan Yang  1   2 , Han Jin  1   2 , Fangfang Fan  1   2 , Xizi Zheng  3 , Hongyu Yang  3 , Haichao Li  4 , Yan Zhang  1   2   5 , Jianping Li  1   2   5
Affiliations

Association Between Average Plasma Potassium Levels and 30-day Mortality During Hospitalization in Patients with COVID-19 in Wuhan, China

Shengcong Liu et al. Int J Med Sci. .

Abstract

Background: Coronavirus disease 2019 (COVID-19) has resulted in more than 610,000 deaths worldwide since December 2019. Given the rapid deterioration of patients' condition before death, markers with efficient prognostic values are urgently required. During the treatment process, notable changes in plasma potassium levels have been observed among severely ill patients. We aimed to evaluate the association between average plasma potassium (Ka +) levels during hospitalization and 30-day mortality in patients with COVID-19. Methods: Consecutive patients with COVID-19 hospitalized in the Zhongfaxincheng branch of Tongji Hospital in Wuhan, China from February 8 to 28, 2020 were enrolled in this study. We followed patients up to 30 days after admission. Results: A total of 136 patients were included in the study. The average age was 62.1±14.6 years and 51.5% of patients were male. The median baseline potassium level was 4.3 (3.9-4.6) mmol/L and Ka + level during hospitalization was 4.4 (4.2-4.7) mmol/L; the median number of times that we measured potassium was 4 (3-5). The 30-day mortality was 19.1%. A J-shaped association was observed between Ka + and 30-day mortality. Multivariate Cox regression showed that compared with the reference group (Ka + 4.0 to <4.5 mmol/L), 30-day mortality was 1.99 (95% confidence interval [CI]=0.54-7.35, P=0.300), 1.14 (95% CI=0.39-3.32, P=0.810), and 4.14 (95% CI=1.29-13.29, P=0.017) times higher in patients with COVID-19 who had Ka + <4.0, 4.5 to <5.0, and ≥5.0 mmol/L, respectively. Conclusion: Patients with COVID-19 who had a Ka + level ≥5.0 mmol/L had a significantly increased 30-day mortality compared with those who had a Ka + level 4.0 to <4.5 mmol/L. Plasma potassium levels should be monitored routinely and maintained within appropriate ranges in patients with COVID-19.

Keywords: COVID-19; Mortality; Potassium; Prognosis.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Smooth curve of average plasma potassium level with 30-day mortality during hospitalization in patients with COVID-19
Figure 2
Figure 2
Kaplan-Meier curves of 30-day mortality
See this image and copyright information in PMC

References

    1. Tu H, Tu S, Gao S. et al. Current epidemiological and clinical features of COVID-19; a global perspective from China. J Infect. 2020;81(1):1–9. - PMC - PubMed
    1. Paules CI, Marston HD, Fauci AS. Coronavirus Infections-More Than Just the Common Cold. JAMA. 2020;323(8):707–708. - PubMed
    1. Lu H, Stratton CW, Tang Y-W. Outbreak of pneumonia of unknown etiology in Wuhan, China: The mystery and the miracle. J Med Virol. 2020;92(4):401–402. - PMC - PubMed
    1. Tongyoo S, Viarasilpa T, Permpikul C. Serum potassium levels and outcomes in critically ill patients in the medical intensive care unit. J Int Med Res. 2018;46(3):1254–1262. - PMC - PubMed
    1. Xi H, Yu R-H, Wang N. et al. Serum potassium levels and mortality of patients with acute myocardial infarction: A systematic review and meta-analysis of cohort studies. Eur J Prev Cardiol. 2019;26(2):145–156. - PubMed