Electrolyte Abnormalities in Patients Hospitalised with COVID-19 in the Southern Gaza Strip, Palestine: A Retrospective Case-Control Study

Introduction: Coronavirus Disease-2019 (COVID-19), has caused, nearly 18 million deaths worldwide, many more hospitalisations, and severe economic and social disruption, as of March 2022. Malnutrition and electrolyte imbalance can lead to immune system dysfunction, which can increase the risk of infection. Aim: To evaluate the electrolyte imbalance and other biomarkers in COVID-19 patients and also, to compare these parameters with healthy individuals. Materials and Methods: A retrospective case-control study was conducted in the Department of Medical Laboratory Sciences at European Gaza Hospital, Southern Gaza Strip, Palestine. The duration of the study was four months, from February 2022 to May 2022. A total of 200 participants were included in the study, out of which 100 patients were diagnosed with COVID-19 infection by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test and 100 healthy individuals were recruited from blood bank donors and comprehensive Screening Department. Biochemical profile; Fasting Blood Glucose (FBG), urea, Creatinine (Cr), Aspartate Aminotransferase ( AST), Alanine Aminotransferase (ALT), total Creatinine Kinase (CK-total), Creatine Kinase (CK) isoenzyme CK and electrolytes (Na, K, phosphorous, and Mg, ionised calcium, total calcium, and Cl) were assayed. Data were statistically analysed using Student's t-test and Chi-square test. Results: The mean age of the study participants was 54.1 +/- 12.2 years for cases and 54.3 +/- 12.4 years for controls. A total of 200 subjects, both the groups had 34 (34.0%) males and 66 (66.0%) females, which was not statistically significant (p-value>0.05). COVID-19 patients had significantly higher values of Na (141.9 +/- 4.6 vs 139.7 +/- 3.1; p<0.001), K (4.6 +/- 0.9 vs 4.3 +/- 0.5; p-value=0.001), Cl (108.7 +/- 5.3 vs 101.1 +/- 4.0; p<0.001), P (4.6 +/- 0.6 vs 4 +/- 1.4; p<0.001), and Mg (2.1 +/- 0.2 vs 1.7 +/- 0.3; p<0.001). However, they had lower Ca ionised (1.0 +/- 0.1 vs 1.1 +/- 0.1; p<0.001) and total Ca (8.4 +/- 0.9 vs 9.1 +/- 1.1; p<0.001). Furthermore, COVID-19 patients had significantly higher levels of biomarkers of other biochemical profiles compared to healthy controls. Conclusion: As compared to healthy individuals, patients hospitalised with COVID-19, exhibited alterations in their electrolyte balance and other biochemical markers. Management of these parameters to get homeostasis, could that warrant opportunities to reduce morbidity and mortality of disease.