Can COVID-19 Trigger Hyperkalemia?

Our body needs many nutrients to remain healthy. Potassium is one such essential mineral that the body needs. However, there is such a thing as having too much potassium in the body, which can be harmful. Hyperkalemia is a term used to describe high levels of potassium in the blood. If left untreated, hyperkalemia can be dangerous to your health. In the last two years, the world has been battling the COVID-19 pandemic, and high potassium levels have been found to be common in patients hospitalized with the novel coronavirus infection. Read on to find out if COVID-19 can trigger hyperkalemia.

COVID-19 and Hyperkalemia

High potassium levels, a condition known as hyperkalemia, have been found to be common in patients who are getting hospitalized with COVID-19. (1,2,3) It has been found that COVID-19 can attack the kidneys, thus triggering hyperkalemia. People with heart failure, kidney disease, and diabetes have been found to be at a higher risk of developing hyperkalemia. (4,5,6) Generally, the body uses the potassium it needs and then filters out and removes the excess amount of potassium from the kidneys. The kidneys flush out any extra potassium through urine. But, when you have kidney disease, diabetes, or heart disease, the body is unable to do a proper job of filtering out the excess potassium in the bloodstream. (7,8) People with these health conditions are also at a higher risk of developing a severe illness from contracting the novel coronavirus. (9)

Can COVID-19 Cause Hyperkalemia?

Having a COVID-19 infection can cause dangerous problems with your kidney, which can lead to hyperkalemia. The novel coronavirus attacks the kidneys, which causes reduced kidney function. This is believed to be one of the causes of hyperkalemia in people with COVID-19. Another cause could be the sudden increase in hormones and inflammatory immune cells that the novel coronavirus infection causes.

People with pre-existing kidney disease and those who develop kidney problems due to the COVID-19 infection are both at an increased risk of developing hyperkalemia. (10,11)

According to research by the US Centers for Disease Control and Prevention (CDC), the risk of developing severe illness from COVID-19 is exceptionally high in people who have any stage of chronic kidney disease (CKD). (12) Research also shows that acute kidney injury (AKI) can affect nearly 40 percent of people who get hospitalized with the coronavirus. (13)

A study carried out in New York City during the start of the coronavirus pandemic discovered that out of COVID-19 patients, the one who had acute kidney injury, almost half of them died. (14) Other findings have also indicated that the death rate amongst those who require dialysis was almost as high as 79 percent.

Having Hyperkalemia Can Make COVID-19 More Dangerous

High potassium levels are commonly found in people who get hospitalized with COVID-19. Having hyperkalemia increases the risk of dying from COVID-19. A study carried out in China found that half the patients with COVID-19 who had high blood potassium levels of 5 millimoles per liter (mmol/L) died. This compared to 14 to 20 percent of patients who had lower potassium levels. (15) The normal blood levels of potassium should fall within a range of around 3.5 to 5 millimoles per liter (mmol/L). (16) However, many laboratories use slightly varying levels.

Conclusion: Is It Possible To Protect Yourself?

A simple blood test can tell you your potassium levels. If you have certain risk factors for hyperkalemia, including kidney disease, diabetes, heart disease, or diabetes, it is better to get your potassium levels tested from time to time. If you are diagnosed with hyperkalemia, make sure to talk to your doctor about how to adjust your diet to a low potassium one, take medications to lower your potassium levels, and lead an overall healthy lifestyle. Lower potassium levels can help reduce your risk of developing some serious illness if you contract COVID-19. Research has also shown that rapidly addressing high potassium levels in people who are admitted to the hospital with COVID-19 can help lower the risk of death. (17)

The combination of hyperkalemia and COVID-19 can lead to negative and dangerous health outcomes. This is why getting a simple blood test to help diagnose high potassium levels and begin treatment at the earliest can help protect your health.

References:

  1. Hollander-Rodriguez, J.C. and Calvert, J.F., 2006. Hyperkalemia. American family physician, 73(2), pp.283-290.
  2. Parham, W.A., Mehdirad, A.A., Biermann, K.M. and Fredman, C.S., 2006. Hyperkalemia revisited. Texas Heart Institute Journal, 33(1), p.40.
  3. Evans, K.J. and Greenberg, A., 2005. Hyperkalemia: a review. Journal of intensive care medicine, 20(5), pp.272-290.
  4. Uribarri, J., Oh, M.S. and Carroll, H.J., 1990. Hyperkalemia in diabetes mellitus. Journal of Diabetic Complications, 4(1), pp.3-7.
  5. Takaichi, K., Takemoto, F., Ubara, Y. and Mori, Y., 2007. Analysis of factors causing hyperkalemia. Internal Medicine, 46(12), pp.823-829.
  6. Einhorn, L.M., Zhan, M., Walker, L.D., Moen, M.F., Seliger, S.L., Weir, M.R. and Fink, J.C., 2009. The frequency of hyperkalemia and its significance in chronic kidney disease. Archives of internal medicine, 169(12), pp.1156-1162.
  7. Lazich, I. and Bakris, G.L., 2014, May. Prediction and management of hyperkalemia across the spectrum of chronic kidney disease. In Seminars in nephrology (Vol. 34, No. 3, pp. 333-339). WB Saunders.
  8. Sarwar, C.M., Papadimitriou, L., Pitt, B., Piña, I., Zannad, F., Anker, S.D., Gheorghiade, M. and Butler, J., 2016. Hyperkalemia in heart failure. Journal of the American College of Cardiology, 68(14), pp.1575-1589.
  9. Fauci, A.S., Lane, H.C. and Redfield, R.R., 2020. Covid-19—navigating the uncharted.
  10. Wang, K., 2004. “Pseudoinfarction” pattern due to hyperkalemia. New England Journal of Medicine, 351(6), pp.593-593.
  11. Adapa, S., Chenna, A., Balla, M., Merugu, G.P., Koduri, N.M., Daggubati, S.R., Gayam, V., Naramala, S. and Konala, V.M., 2020. COVID-19 pandemic causing acute kidney injury and impact on patients with chronic kidney disease and renal transplantation. Journal of clinical medicine research, 12(6), p.352.
  12. Centers for Disease Control and Prevention. 2021. COVID-19 and Your Health. [online] Available at: < https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html#chronic-kidney-disease> [Accessed 23 October 2021].
  13. Chan, L., Hindi, J. and Nadkarni, G.N., 2021. COVID-19: The Kidneys Tell a Tale. American Journal of Kidney Diseases, 77(2), p.175.
  14. Ng, J.H., Hirsch, J.S., Hazzan, A., Wanchoo, R., Shah, H.H., Malieckal, D.A., Ross, D.W., Sharma, P., Sakhiya, V., Fishbane, S. and Jhaveri, K.D., 2021. Outcomes among patients hospitalized with COVID-19 and acute kidney injury. American Journal of Kidney Diseases, 77(2), pp.204-215.
  15. Liu, S., Zhang, L., Weng, H., Yang, F., Jin, H., Fan, F., Zheng, X., Yang, H., Li, H., Zhang, Y. and Li, J., 2021. Association between average plasma potassium levels and 30-day mortality during hospitalization in patients with COVID-19 in Wuhan, China. International journal of medical sciences, 18(3), p.736.
  16. Ods.od.nih.gov. 2021. Office of Dietary Supplements – Potassium. [online] Available at: < https://ods.od.nih.gov/factsheets/Potassium-HealthProfessional/> [Accessed 23 October 2021].
  17. Linkinghub.elsevier.com. 2021. Redirecting. [online] Available at: < https://linkinghub.elsevier.com/retrieve/pii/S0735675719308034> [Accessed 23 October 2021].

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