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.