MO113: Estimation of Hypocalcaemia, Hypoalbuminemia and Hypomagnesaemia Prevalence in Patients with COVID-19 and its Relationship with Clinical Manifestations and Disease Progression

BACKGROUND AND AIMS

Electrolyte abnormalities are common among patients with coronavirus disease 2019 (COVID-19). This study aims to investigate the electrolyte changes in severe and non-severe COVID-19 patients. Hypocalcaemia, hypomagnesaemia and hypoalbuminemia and their relationship with the severity of symptoms and prognosis will also be determined.

METHOD

We enrolled 270 COVID-19 patients. Serum tests were taken from each patient on the day of admission to check the level of variables. Thereon, calcium, magnesium and phosphorus levels were measured twice a week and albumin levels were measured once a week. Variables such as PTH and 25 (OH) D were measured once at the beginning of the study. Other laboratory results like complete blood count, C-reactive protein and clinical data such as arterial blood oxygen levels, length of stay in the ICU and the treatment regimen were extracted from patients' medical records and history. Finally, patients were categorized as mild, moderate, severe and critical group based on the severity of the disease. The data analyses were carried out via SPSS software (version 21.0).

RESULTS

Of 270 patients, 135 people (50%) were men. The mean age of patients was 46.7 years. Based on the severity of the disease, 91 patients had mild disease, 90 patients presented with moderate disease, 54 patients were in severe condition and 35 patients were critical. Hypocalcaemia (Ca 2+ ≤8.6 mg/dL) was detected in 49 patients (18.1%) on admission. The mean of serum magnesium, phosphorus and albumin levels on admission was 2.2 ± 0.22 mEq/L, 3.39 ± 0.79 mg/dL and 4.49 ± 0.66g/dL, respectively. Phosphorus level was lower than 2.63 mg/dL in 11 patients (4.07%) and 43 patients (15.92%) had hypoalbuminemia. The mean 25(OH) D level was 32.92 ± 10.29 μg/L; therefore, 182 patients (67.40%) fall within the normal range (>30 μg/L).

CONCLUSION

Patients with mild and moderate disease tend to develop hypocalcaemia, hypoalbuminemia and hypomagnesaemia more often than severe and critical COVID-19 patients during treatment. 25(OH) D deficiency rate was higher in the moderate group. Patients with hypocalcaemia during treatment had higher mortality than other patients. We recommend electrolytes be measured at initial presentation and serially monitored during hospitalization in order to establish timely and appropriate corrective actions and prevent the serious complications of the disease.

MO888QUALITY OF LIFE AND QUALITY OF SLEEP IN MAINTENANCE HEMODIALYSIS PATIENTS: REPORTS FROM TWO HEMODIALYSIS CENTERS IN IRAN

Background and Aims

Patients with End Stage Kidney Disease (ESKD) usually tend to have lower Quality of Life (QoL) compared to the general population. The purpose of this study was to determine the QoL and quality of sleep in patients on maintenance hemodialysis (MHD) and its relation with medical factors.

Method

This descriptive-analytical study was performed on 145 patients on MHD in two hospitals affiliated to Abadan University of Medical Sciences. Patients' QoL was assessed via KDQOL-SF questionnaire. For sleep quality, Pittsburgh Sleep Quality Questionnaire (PSQI) was used. Demographic information of patients, type of vascular access, history of dialysis, and frequency and duration of each dialysis session were collected. The average results of related laboratory tests in the last six months, were also recorded for each patient.

Results

Of 145 MHD patients, 81 (55%) were men and 64 were women. Most patients (53%) were between 30 and 60 years old. Illiteracy was present in 48 (33%) patients. Unemployed patients accounted for 70% of patients (99) and most of the participants (83.44%) lived in the city. Of 145 patients, 102 (70.34%) were married, 20 (13.79%) were single, and the rest were widows. The mean dialysis adequacy of patients was 1.14, and 53% had dialysis adequacy less than 1.2. The average quality of life score was 66.00 ±13, suggesting a high QoL in this group of patients. literacy was significantly associated with QoL score (P<0.001). Likewise, there was significant association between QoL score and income level (p <.001), the effect of Kidney disease on life (p <.001), working status (p <.009), social functioning (p <.046), and marital status (p <.001). The quality of social interactions was significantly associated with residence location (p <.001). On the other hand, the presence of Kidney disease burden, sexual dysfunction, unemployment, role emotional and role physical, was associated with low QoL scores. We found a significant relationship between hemoglobin level and cognitive function (p <.001, r= .075). In addition, significant relationships between phosphorus levels and physical function (p=.021) and role emotional (P:0.04) were observed. Seemingly, phosphorus levels were inversely related with sexual function in our patients (p <0.001, r= - .013). Our data also suggested that serum calcium levels may have an impact on the patients’ social function (p=.038). The mean score of sleep quality was 7.00±4.00. Most of the patients (61%) had a PSQI>5, indicating a poor sleep quality. High sleep quality (PSQI<5) is significantly associated with low age and high-income level. There was also a significant relationship between the average sleep quality and general health (p <0.001, r= -0.206), social function (p= 0.018, r=-0.208), and energy fatigue (p <0.001, r= -0.309).

Conclusion

Our study showed that a wide range of determinants, including demographic, socioeconomic and disease-related factors can significantly influence the QoL and sleep quality in ESKD patients undergoing hemodialysis. Among them, modifiable factors including laboratory test results, socioeconomic determinants and psychosocial status should be addressed and accordingly treated and solved. Hence, an improvement in both the QoL and sleep quality of maintenance hemodialysis patients will be expected.

Keywords

Hemodialysis, Quality of life, Sleep quality, Sociodemographic characteristics.