Dyschloremia During Severe COVID‑19 Infection in Intensive Care Unit Patients

Background: Dyschloremia is one of the most prevalent abnormalities that is highly associated with a high level of mortality in intensive care unit (ICU) patients. The current study evaluated serum chloride levels in COVID-19 patients hospitalized in the ICU. Methods: This cross-sectional study was conducted on 245 patients with severe COVID-19 who were admitted to the intensive care unit (ICU). Electrolytes, albumin, liver function test, complete blood count, serum chloride, and VBG were among the laboratory markers compared. The Chi-square, t-test, and logistic regression models were used to examine the relationship between these markers and the key outcomes, which included severity, mortality, intubation, and hospitalization. Findings: The Mean±SD age of patients was 58.16±17 years. The mean serum chloride level in the studied patients was 109.6±5.1 with a range of 100-134. According to the regression logistic model, variables like age, intubation status, pH, and chlorine levels significantly affected the outcome of COVID-19 disease. Patients with acidosis were 4.7 times more likely to die than those with alkalosis (P 0.001). The chance of dying in hyperchloremia is 2.38 times more compared to the normochloremia group (P 0.009). Conclusion: Patients with severe COVID-19 may present with chlorine abnormalities, including hyperchloremia. Hyperchloremia is also associated with poor clinical outcomes and a higher mortality risk. This relationship was independent of acid-base disorder.