Posted on Authorea 27 Mar 2021 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.161684943.32764821/v1 | This a preprint and has not been peer reviewed. Data may be preliminary. ae nt STGad seaeMtooiaoNgad,Mln Italy; Milan, Niguarda, Metropolitano Ospedale Grande [email protected] ASST Hemato- and Unit, Oncology Email: E-mail: eases Epis, [email protected] of Italy; Massimiliano 1Department Italy; Email:[email protected]; E-mail: Al- Oscar Milan, contributed Milan, Niguarda, Claudia [email protected]; MD6, equally Milan, PhD1, [email protected] Colombo, authors E-mail: Arianna of MD. Fabrizio two Vismara [email protected]; study University Cento, MD5, *These Chiara case-control Valeria Oncology, Tarsia, PhD1,2 a Panetta8, MD3, Paolo MD, Valentina Puoti, SARS-CoV-2: MD4, Romandini MD7, Massimo by Moreno, Alessandra caused Inglese*2, Mauro PhD1, imbalances Elvira teri, electrolyte MD*1, in Pani, differences Sex among and women , among of hypocalcemic frequent prevalence be higher more to a is women with Hypokalemia associated for for is probability OR alterations. men. Notably, infection low SARS-CoV-2 in a p<0.001). and - alteration with 1.03-2.69 Conclusions hypochloremia p<0.0001) an CI hypocalcemia, p=0.005). 4.8-10.6 with 95% 0.4-0.8 IC manifest 1.6, IC (95% (OR to 95% to 7.2 patients 0.63, likely was serum positive (OR as and hypocalcemic for twice p<0.001) higher be ratios were 1.17-2.35 to a Odds women CI patients and had p<0.001). 95% positive p<0.0001) patients 1.67-3.54 1.6, 1.8-4.1 Positive CI (OR CI was 95% 95% Na+ subjects). 2.43, 2.75, serum (OR negative (OR men hypokalemia as of with than and 6% prevalence ED affected continuous vs higher the be a as to (13.7% observed We admitted (Ca++) SARS-CoV-2 - be calcium for Results to and positive probability status. (Cl-) infection patients ethics SARS- SARS-CoV-2 chlorine among and local for (Na+), hypokalemia anonymized sex the test age, in sodium of by with swab repository approved (K+), relation SQL-based nasopharyngeal was their laboratory in study a variables, hospital outcomes The and categorical the as controls. analysis from department considered extracted as gas We emergency automatically negatives blood were the and form. Data a to cases undergone Milan. as admitted 3 had patients patients Area positive who all committee defined 2020 on We recurrent May study rtPCR. the 31st case-control by of to CoV-2 a one have March as COVID-19 performed imbalances 1st We of electrolyte from - prognosis described (ED) Methods and have characteristics progression COVID-19. clinical in of patients’ differences features on sex studies regarding this, evidences Besides spread, emerged. SARS-CoV-2 Since - Background Abstract 2021 27, March 3 2 1 Bellone Tarsia Romandini Alessandra Pani Arianna SARS-CoV-2: study by case-control caused a imbalances electrolyte in differences Sex ’lrsaitc r oslac Training & Consultancy - srl L’altrastatistica Hospital Niguarda Milano di Studi Universit`a degli 2 arzoColombo Fabrizio , 2 n rnec Scaglione Francesco and , 1 liaInglese Elvira , -al liaigeeopdlngad.t -al [email protected]; E-mail: [email protected]; E-mail: S lnclCeityadMcoilg,AS rneOpdl Metropolitano Ospedale Grande ASST Microbiology, and Chemistry Clinical 2SC 1 eeiaD Ruscio Di Federica , 2 sa Epis Oscar , 2 asm Puoti Massimo , 1 D,Fdrc iRsi,M2 ihl Senatore Michele MD2, Ruscio, Di Federica MD1, , 1 2 aetn Panetta Valentina , 2 nraBloe D n rnec Scaglione, Francesco and MD9 Bellone, Andrea , 2 ihl Senatore Michele , 1 2 -al ran.aiuiii;Emi:vale- E-mail: [email protected]; E-mail: aei Cento Valeria , 3 haaVismara Chiara , 1 1 lui Alteri Claudia , ar Moreno Mauro , Ifciu Dis- 3Infectious -al mas- E-mail: 2 Andrea , 1 , 2 Paolo , 1 MD, , Posted on Authorea 27 Mar 2021 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.161684943.32764821/v1 | This a preprint and has not been peer reviewed. Data may be preliminary. h ol a ensrgln ofih h oe ooaiu ASCV2 sso stevrssra in spread virus the as soon As 2019 SARS-CoV-2. December coronavirus Since novel to INTRODUCTION the also appears fight patients men. Positive Hypokalemia to among struggling men. alteration. hypocalcemia been than sodium and has affected and women world be hypochloremia the among to frequent hypocalcemia, features likely more of recurrent as prevalence be twice the higher were of a studies women one had and Besides, as SARS-CoV-2, emerged. imbalances for have electrolyte positive COVID-19 described of have COVID-19. prognosis characteristics and of and women clinical progression 0.4- among patients’ in IC frequent on differences 95% more 7.2 sex 0.63, is was regarding chlo- (OR Hypokalemia dence hypocalcemic men. serum hypocalcemic alterations. be among and be cemia sodium to to p<0.001) hypocal- and patients women 1.17-2.35 patients hypochloremia positive for CI positive cemia, for probability for 95% hypocal- low OR ratios twice 1.6, Notably, a Odds were with p=0.005). (OR p<0.001). women 0.8 p<0.0001) was p<0.001). 1.03-2.69 and 4.8-10.6 1.67-3.54 Na+ CI p<0.0001) IC CI serum probability 95% 1.8-4.1 (95% 95% in higher CI 1.6, 2.43, a alteration 95% (OR (OR had an 2.75, rine men patients with (OR than Positive and hypokalemia manifest affected sex with to be subjects). age, ED to negative with the likely of relation to as 6% their admitted vs in be (13.7% variables, to categorical SARS-CoV-2 the chlorine as for by (Na+), and positive approved sodium SQL- continuous (K+), status. by was laboratory potassium as infection SARS-CoV-2 study hospital outcomes (Ca++) the SARS-CoV-2 for The as from calcium considered test extracted We controls. and 31st swab automatically form. as (Cl-) were to nasopharyngeal anonymized Data negatives March a in and Milan. 1st repository and 3 cases based from analysis Area as (ED) committee gas department patients ethics blood emergency local positive a have the defined undergone characteristics We to COVID-19. had clinical rtPCR. admitted of patients’ who patients features on 2020 all recurrent May studies on the of study this, case-control one Besides a as imbalances emerged. have electrolyte COVID-19 described of prognosis and ABSTRACT ++39-0250317050 Fax: ++39-0250316950 Phone: Italy [email protected] Hematology, e-mail- – Onco and Oncology of Department address: Mailing Milan of University Toxicology Hemato-Oncology and and Pharmacology Oncology Clinical of of Department School Postgraduate the of Director Assistant Pharmacology of Professor Assistant Pani Arianna author Milan, Niguarda, Corresponding Metropolitano Italy; Ospedale Grande ASST Milan, Department, Italy; 9Emergency Italy Niguarda, Rome, Training, Metropolitano & Ospedale Italy; Milan, Grande ASST [email protected] Department, Italy; Milan, Italy; Medicine Niguarda, Metropolitano Milan, Ospedale Grande Niguarda, tano [email protected] -al [email protected] E-mail: Background ocuin - Conclusions -al [email protected] E-mail: htde hsatceadd? article this does What ic ASCV2sra,eiec eadn e ieecsi progression in differences sex regarding evidence spread, SARS-CoV-2 Since - hti led nw bu hstopic? this about known already is What ASCV2ifcini soitdwt ihrpeaec fhypokalemia, of prevalence higher a with associated is infection SARS-CoV-2 eut - Results Hatcr aaeetDprmn,AS rneOpdl Metropoli- Ospedale Grande ASST Department, Management 4Healthcare Remtlg nt STGad seaeMtooiaoNiguarda, Metropolitano Ospedale Grande ASST Unit, 7Rheumatology -al [email protected] E-mail: eosre ihrpeaec fhpklmaaogpatients among hypokalemia of prevalence higher a observed We eosre ihrpeaec fhpklmai patients in hypokalemia of prevalence higher a observed We Bottsisoc,Latattsiasl-Consultancy srl L’altrastatistica office, 8Biostatistics 2 -al [email protected] E-mail: ic ASCV2sra,evi- spread, SARS-CoV-2 Since Pemlg nt ASST Unit, 5Pneumology ehd - Methods eperformed We -al fab- E-mail: 6Internal Posted on Authorea 27 Mar 2021 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.161684943.32764821/v1 | This a preprint and has not been peer reviewed. Data may be preliminary. ausdrvn rmti nlss oaodptnilba u otecmaio fdffrn ehd.We [12]. methods. formula different MDRD of the using comparison eGFR the calculating to by electrolyte disease, due the renal bias consider as potential to such decided avoid modifiers of we to effect ED, imbalances potential the analysis, defined analyzed to this We accepted in from patients of presented status. deriving categorical majority ranges values infection the as to v) on SARS-CoV-2 and according years; performed and continuous was Ca++, 65 analysis as sex and below both age, Cl- aged (Ca++) ii) Na+, with Males calcium years; K+, relationship iv) and 65 their years; below (Cl-) years. over in 75 75 chloride aged over and Females variables, over (Na+), aged years i) Males aged sodium 75 vi) Females groups: (K+), years; and iii) six 75 potassium 65 and into years; 65 between combined 75 between years, range aged and Patients 65 Males age 65 (under and controls. between age sex as aged to to negatives Females according according and Health and classes cases World years) Plus three as the 75 TMCOVID-19 in defined or to categorized were (GeneFinder positivity according patients then rtPCR performed the Positive were Seegene) by to Assay, guidance. SARS-CoV-2 according nCoV (WHO) for counts, TM2019- controls Organization cell Allplex test and ELITech; blood swab cases Kit, white nasopharyngeal defined RealAmp glucose, We the blood procedures pH, to own profile, all creatinine. negativity our electrolyte for for neutrophils, stackable regarding warranted counts, data are are results collected system lymphocyte We These Labora- gas study. central [11]. blood this devices to and 500 performance, in and arterial Compared RAPIDPoint consideration the (both into Siemens System. analysis taken and POC Gas gas parameters years from tested Blood blood obtained 18 one 500 results over least RAPIDPoint analyzers, at Siemens age tory of POC Department, were: using Emergency criteria performed the in venous) Inclusion manence per- infection. the age. SARS-CoV-2 during and pa- for biochemical sex categorize the screened SARS-CoV-2, and collect to and (ED) to 1st negativity) department able period (or were emergency the we positivity the way COVARIATES to to their this referred fields admittance on In data data), at The based extracted ward. patients personal tients the hospital of for without performed. results, profile truncation tests patient service microbiological a ID, the of and (with tests identifies execution May), type results uniquely tests 31st the data laboratory lab - that and March extract of extracted string laboratory day department to query numeric date the This requesting created (a birth in was the ID sex, birth. performed query patient’s execution, of tests a date of were: study, the and date extracted this of gender the conduct than results on to other analytical based purpose information all the personal store With no we with Declaration repository. hospital, 1964 SQL-based our an the At in of Italy. principles the in Observational with Hospital of accordance in Reporting obtained in differences was the content conducted Sex guidelines. Strengthening informed was Signed sex. study ap- Helsinki. 92–15032020). and was This of (prot. age protocol Milano participant. study to 3 The each according Area METHODS for Committee distribution study Ethics case-control its with the patients a and by among SARS-CoV-2 proved SARS-CoV2: aforemen- cohort imbalances by in electrolyte large the of caused and prevalence a Despite imbalances COVID-19 the electrolyte in (RAS). examine in to infection system disturbances was CoV-2 study renin-angiotensin electrolyte this SARS- regarding angiotensin-converting the of to known aim on The SARS-CoV-2 still impact of infection. is mecha- binding possible little This output the a evidences, K+ by loss. with urinary tioned caused urine mean (ACE2) disruption K+ higher the 2 increased have a by for enzyme Authors had explained implication hypokalemia. subjects be possible hypokalemic of COVID-19. could et that a degree nism with patients, Chen suggesting higher hospitalized of patients, a patients sample 9]. non-hypokalemic with small among than 8, associated a subjects [1, was disease in hypokalemic disease abnormalities shown, the of the also (Cl-) disease between prevalence of chloride than severity association high and other the the a (Ca++) Furthermore, disease highlighted described calcium the have [10] (K+), studies of COVID-19 Few 4]. potassium al. manifestations on [7]. (Na+), [3, clinical genetics studies to sodium to in death [5], Early and and differences and response [6] mortality. immune sex women disease in and and of severe differences men severity impact among sex more the to subjects a investigated smoking differences have and of these prevalence for sex the emerged reasons in male Evidences the differences between att AASOURCES DATA ecniee ooto ainsamte oteE rm1 from ED the to admitted patients of cohort a considered We hscs-oto td a enpromda h STGMNiguarda GOM ASST the at performed been has study case-control This 3 Studies al 1 Table OUTCOMES nEieilg SRB)reporting (STROBE) Epidemiology in eeaigtefc htabodgas blood a that fact the Leveraging . TD AINSAND PATIENTS STUDY sotoe,w considered we outcomes, As st ac o31 to March st a 2020 May Posted on Authorea 27 Mar 2021 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.161684943.32764821/v1 | This a preprint and has not been peer reviewed. Data may be preliminary. p003,wmnblw6 er p001.I oe vr7 er twspsil ont difference a note to possible was it years 75 (p=0.069). over significance women years of statistical 65 In classes reach below (p<0.001). all men not for years did for significant which 65 similar statistically was was below patients prevalence women negative and The ( (p=0.013), positive SARS-CoV2. analyses age between Further for difference of here.] The positive class age. about woman and ( 3 among sex [Table clusterization patients to infection. a hypokalemic divided according SARS-CoV-2 ( showed then with population We state Results group the status. kalemic the of sex. SARS-CoV-2 their in to and to hypokalemia particular negativity, >75) with according in or patients cohorts 75; and positivity controls parameters, to SARS-CoV-2 those and 75 65 of to cases under basis >65; according values aged the (years K+ on patients ages ANOVA serum of three-way of prevalence a the classes lower with in three parameter a here.] higher continuous significantly was about a was 2 there years as [Table while 75 212). and 145), (30.2%, 65 (20.6%, years between cohort aged positive patients of SARS-CoV-2 prevalence (3.80 The Ca prevalence. and disease (7.23 K+ values for two lactate controls from the 1.20 and swabs different between pH significantly nasopharyngeal characteristics mean panel the baseline lower electrolyte Patients to 274/710), positive (39%, negative. in resulted subjects resulted summarized patients 619 of are (53%) and study 710 groups SARS-CoV-2 cohort for electrolyte included. retrospective test in were the rtPCR 1 differences For patients from Sex RESULTS ED 1347 study the significant. analysis, case-control to statistically admitted a considered patients CI were consecutive and SARS-CoV2: <0.05 ratios by values Odds caused P performed. sex imbalances were and reported. natremia group (CI were abnormal age 95% positivity, and intervals 95% SARS-CoV-2 hypocalcemia confidence considering hypochloremia, and of regression hypokalemia, (ORs) presence SARS- logistic on ratios between Multivariable and Odds relationship reported. post-hoc age separately. the were evaluate for imbalances of 95%) to electrolyte performed class performed and was or were sex, infection test test, analyses CoV-2 comparisons among test. regression chi-square multiple differences Shapiro-Wilk logistic Tukey’s and Several evaluate by values. t-test evaluated comparison. to potassium with was performed on distribution tested infection was normality SARS-CoV-2 been test percentages of have ANOVA and Assumption three-way cohorts number two A respectively. with of and the test, support variables exact between in continuous Fisher Differences for phenotypes Pheno- deviation their categorical. ”Human standard to the for and SARS-CoV2 of mean between terms here.] with information link the about summarized use the 1 making data, [Table we clinical promote purpose, research. outcomes enrich better disease this to describe infectious to demonstrated to for (HPO) been this, tool has electronic for Ontology” useful HPO in and type available of [13] a power information diseases is The the infectious granularity. all (HPO) including of have Ontologies levels to different Phenotype preferable at Human be available would the it and medicine, precision form to closer get To ± .0v 1.12 vs 0.10 ± .7mqlrsetvl) ohchrswr ooeeu o g,eF n renal and eGFR age, for homogeneous were cohorts Both respectively). mEq/l 0.07 al 2 table h aechr a hrceie yalwrpeaec ffemale of prevalence lower a by characterized was cohort case The . POTASSIUM TTSIA ANALYSIS STATISTICAL st ac o31 to 1 March al 4 Table 4 eaaye h itiuino eu +values K+ serum of distribution the analyzed We al 3 Table loe st bev ihrpeaec of prevalence higher a observe to us allowed ) st a 00wohdudroebodgas blood undergone had who 2020 May ± n bevdahge rvlneof prevalence higher a observed and ) .7ad1.72 and 0.37 ± .9v 4.11 vs 0.49 ainscaatrsiswere characteristics Patients ± .5mql n an and mEq/l) 1.45 ± .2mqland mEq/l 0.62 iue1 Figure of ) Posted on Authorea 27 Mar 2021 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.161684943.32764821/v1 | This a preprint and has not been peer reviewed. Data may be preliminary. oiiiyadae smr hntieta h n o e O .3 5 I16-.4p001 ( p<0.001) 1.67-3.54 CI 95% 2.43, (OR ( men for p<0.001) one 1.8-4.1 the CI study than twice 95% than 2.75, nearly more 2 was (OR is hypokalemia age, infection with and ED SARS-CoV-2 positivity the with to ( admitted patients patients be for non-infected 2 to for probability higher normalization, 4 one the [Table times data the sex, hypokalemia three and than of experiments. with present age twice of method to for is SARS-CoV-2 range adjusting de- classical with ED wide regression, patients standard the a for a combined OR to of across the and admission regression, application data at difference logistic standardizing The binary mean At of weighted here.] way (1992). of about intensity a Tiao ratio Z-score provides in and the transformation, analysis taking Box z-score the by gener- for to and transformed constructed according for were clustering is results used viation applying score test was before All Z linkage k-means average dendogram. using signal. the and pre-processed and distance were heatmap Euclidean results the ating test groups. The all process. between clustering potassium compare to performed 1. Figure .[al bu ee]Sxdffrne neetoyeiblne asdb ASCV:acase-control a SARS-CoV2: by caused SARS-CoV-2 imbalances for electrolyte adjusting in hypokalemia, differences with Sex ED here.] the about to 5 admitted [Table be ). to probability the women, For ). eta fPs o ue’ D etresults. test HDS Tukey’s hoc Post of Heatmap 5 ue’ utpecmaiosts was test comparisons multiple Tukey’s A al 5 Table .A utvral logistic multivariable At ). Figure Figure Posted on Authorea 27 Mar 2021 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.161684943.32764821/v1 | This a preprint and has not been peer reviewed. Data may be preliminary. TE ELECTROLYTES OTHER eadn arma eosre ihrpeaec fbt ainswith patients both of prevalence higher a observed we natremia, Regarding 6 Posted on Authorea 27 Mar 2021 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.161684943.32764821/v1 | This a preprint and has not been peer reviewed. Data may be preliminary. fQ rlnain,aryhisadcricdah e ieecsi lcrlt maacscue by caused imbalances electrolyte in differences Sex reports deaths numerous study of cardiac the case-control explain especially and a help imbalances, endothelial arrhythmias also SARS-CoV2: Electrolyte could necrosis, prolongations, 25]. infection recent and QT SARS-CoV-2 [24, Indeed, dysfunction with of tubules 8-10]. associated tubular on [1, calcium, complex as well and complement manifesting as potassium ACE2 action of reticulum others damage on deposition the and SARS-CoV-2 endoplasmic kidney and Furthemore, of study the of alterations binding this from the receptor. evidences in by release AT1 observed reported caused Ca++ alterations the pathway studies by electrolytes this on of the triggered of acting disruption underlie vasodilation by The membrane could the function 1-7. baso-lateral to angiotensin natriuretic the important by in a induced also on modulation exert explained is ATPase the to ACE2 As in Na+/K+ able of particular the on in is 23]. present especially system, which domain [22, RAS 21], 1-7, binding the cells receptor [20, in tubular a D implied transporters through receptor epithelial vitamin ACE2 sodium a of to is renal use binding ACE2 frequent by of reported [19]. cells more As glycoprotein SARS- human the perspective spike penetrate pathophysiological to the infection. a to From correlated SARS-CoV-2 able [18]. be is by prevention trend osteoporosis could CoV-2 exacerbated a for hypocalcemia patients; women but among male in calcium population, among differences and/or non-positive hypocalcemia sex of Regarding the [17], prevalence the [16]. in elsewhere higher impact age observed to to with is according able trend, also also This are reverse 15], is which women. a [14, ACE2 1-7 observed postmenopausal on angiotensin we estrogens, and of calcium mainly expression pre- the hormones, This between and sex influence ratio the age. female activity increasing hormonal in ACE/ACE2 of with different influence difference decrease a the the by to of women, supported tended expression Among controls an and important patients. lower be the cases male of could a between description and patients the observed hypokalemic highly female in we lies a not of among study with prevalence considered observed [10], this SARS-CoV-2 we of differences to novelty because positive the significant al. 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This similar the population Chen hypokalemia. of a a grade by of but with heterogeneous COVID-19, severity reported compared for lower alter- and hospitalized results a patients electrolytes ED the and only describing the patients from sample hypokalemic to large Differently of admission very prevalence a at patients. on SARS-CoV-2 and conducted non-infected with age study of infected to first according patients the distribution is in At its this ations knowledge, deepening our Materials). infection, To CoV-2 Supplementary (OR SARS- sex. hypocalcemia in and have 4.8-10.6 f imbalances to IC ( probability electrolyte (95% (table p=0.005) lower between 7.2 a females 0.4-0.8 was had SARS-CoV-2 IC of women to 95% infection 32% regression positive subgroups 0.63, logistic SARS-CoV-2 if to six multivariable hypocalcemic with at 16% the being patients and for to of male p<0.0001) OR compared among each the regression hypocalcemia 34%, for logistic groups of controls from to binary Prevalence age independently and 28% sex. and men, cases from and to sex between ranged group compared among differences age women Differences significant on among very based hypocalcemia Materials). cases, and of among Supplementary prevalence status, hypercalcemic lower e were infection a to 0.4% (table to with presented only controls patients and visible infection groups of were subjects infected SARS-CoV-2 age negative 7.4% with and of of in patients sex to tendency 5.3% of for alteration versus compared mild 30% differences hypocalcemia an a nearly no with with Lastly, also ED with ER the Materials) detected Material). the mentary We Supplementary Supple- to d c p<0.001). presents (table (table 1.17-2.35 to hypochloremia among CI probability with differences 95% higher patientspresent these regression, slightly 1.6, However, logistic a (OR At had hyponatremic. natremia Materials). Supplementary more infection Women in were SARS-CoV-2 b Materials). (table men with significant Supplementary while statistically in not hypernatremic a were more groups (table be subjects to positive tended among and hyperrnatremia iue2 Figure ICSINI hschr td,w vlae h association the evaluated we study, cohort this In DISCUSSION ) iue3 Figure 7 C2cevsagoesnI nangiotensin in II angiotensin cleaves ACE2 , Posted on Authorea 27 Mar 2021 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.161684943.32764821/v1 | This a preprint and has not been peer reviewed. Data may be preliminary. ae rfig n aeciia eiinfritleta otn.FS aeciia eiinfrintellectual for interpretation, revision data critical gave to F.S. contributed content. M.M., intellectual for revision. revision analysis critical critical data gave gave to and and contributed to intellectual drafting, for A.R., contributed drafting, V.P., revision paper V.A.F. critical paper management. gave analysis. and P.T., interpretation, interpretation, enrollment F.C., and and patient and O.E., acquisition with F.D.R., analysis data contributed C.V., M.P., acquisition, to and contributed content data acquisition. data A.B., design, and C.A., and design V.C., study conception drafting. study paper to and contributed F.S. understand E.I., to A.P., also investigated further studies. be other CONTRIBUTIONS in should AUTHOR imbalances reported events electrolytes cardiovascular kalemia, of with supplementation Monitoring role immediate association and The prognosis perspectives. the COVID-19 with different better suggested. patients from on in this, be relevant impact important are is should Besides certainly disease, general, study which COVID-19 in this disease outcomes. of electrolytes and of the pathophysiology clinical calcemia of implications the and manifestation Clinical understand severity the women. better in disease for to differences with important and sex retrospective values are its monitor especially findings in lab and continuosly lie our of study to that non-correlation this believe importance of the we limitations with the in The treatments highlights 32] and to [31, This nature ascribed imbalances electrolytes and 30]. and [26-28] hypokalemia COVID-19 [29, manage infection. SARS-CoV2 with hydroxychloroquine of patients impact and and in imbalance macrolides reported calcium and BioRender.com sodium with potassium, on Created ACE2 of Actions 3. Figure 8 Posted on Authorea 27 Mar 2021 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.161684943.32764821/v1 | This a preprint and has not been peer reviewed. Data may be preliminary. eccts1.0(.8 .8(.1 0.627 <0.001 0.002 0.001 <0.001 (6.01) 8.08 (212) 30.2 (145) 20.6 (0.37) 7.23 (9.38) 10.30 (353) 50.3 (226) 36.7 (85) 13.8 (0.19) 7.31 Leucocytes (308) sd) (274) (16.2) 50.0 (mean, 39.0 63.7 mEq/l Lactate, sd) (mean, pH >75 65-75 (21.15) 61.9 years (297) <65 48.2 n) (%, age of Class sd) (mean, Age n) (%, Female Characteristics 2. Table study case-control a population SARS-CoV2: study by of caused imbalances electrolyte in differences Sex term HPO relative and electrolytes for considered ranges abnormality and Normality 1. Table TABLES OF LIST study case-control a SARS-CoV2: by caused imbalances electrolyte in differences Sex if (and, planned fundings as No study the from discrepancies impor- any no FUNDINGS that that reported; and explained. being omitted; been study been have the have registered) of study relevant, account the transparent of and aspects accurate, tant honest, an is manuscript The DECLARATION TRANSPARENCY content. Uiaibelgsi ersino rbblt odvlphpklmafrptet ihSARS-CoV-2 18 with patients .. . . for . . hypokalemia . . develop . . sex. to and probability age of to regression according infection logistic SARS-CoV-2 Univariable and 14 5. kalemia kalemia between to Comparison according 4. distribution population 13 Study 12 population electrolytes 3. study for of considered Characteristics ranges 2. abnormality and Normality 1. neto 15 infection acu C+)Hpclei P0091<11mmol/l 1.1 < mmol/l 96 < HP:0002901 mmol/l 132 Hypocalcemia < HP:0003113 (Ca++) Calcium Hypochloremia mmol/l 3.5 HP:0002902 < (Cl-) Chloride Hyponatremia HP:0002900 (Na+) Sodium Hypokalemia (K+) Potassium .7(.8 .2(.5 0.001 (1.45) 1.72 value P (1.58) 2.17 + SARS-CoV2 (619) - SARS-CoV2 yeclei P0002>14mmol/l 1.4 > mmol/l 1.4 - mmol/l 1.1 107 HP:0003072 > HP:0004363 NOT Hypercalcemia mmol/l Normocalcemia 143 > mmol/l 96-107 HP:0011423 HP:0011422 NOT mmol/l 5.2 > Normochloremia mmol/l 132-143 HP:0003228 HP:0010931 NOT mmol/l 5.2 - Normonatremia 3.5 HP:0002153 HP:0011042 NOT Normokalemia maac ye(P em Range term) (HPO type Imbalance (710) 9 Posted on Authorea 27 Mar 2021 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.161684943.32764821/v1 | This a preprint and has not been peer reviewed. Data may be preliminary. 7 .046 .011 21.01 92.09 28.07 17.07.00.069 0.108 <0.001 0.713 1.00 0.013 78.00 78.20 77.30 88.80 90.70 90.20 78.00 78.20 77.30 88.80 90.70 90.20 71 43 99 103 78 202 71 43 103 99 78 202 84.40 88.90 91.50 83.20 89.70 97.20 92 24 107 134 52 140, 92 24 107 134 140, 20.90 52 21.80 10.30 21.90 8.00 8.10 19 12 12 28 18 7 19 12 12 28 11.00 18 7 7.40 6.80 5.00 1.40 12 8.60 2 8 8 1.10 2 5 0.00 1.70 0.80 1.10 1.80 1.20 0.00 1.70 0.80 1.80 1 1.20 0 2 1 4 1 1 0 2 1 4.60 4 1 11.80 3.70 1.70 4.60 1.40 1.70 11.80 3.70 1.70 1.40 5 1.70 F 19 1 2 F F >75 M 6575 0.227 65