Hypophosphatemia: Unraveling a lethal connection with icu mortality in critically ill COVID-19 patients: a multicenter observational study

Background: Despite a lack of sufficient knowledge about the prevalence and impact of hypophosphatemia in critically ill COVID-19 patients, organ dysfunction, adverse clinical outcomes, and increased mortality have been consistently associated with hypophosphatemia across diverse patient populations...

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Main Authors: Temel Şahin, Hanci Pervin, Hakkı Akbudak Ismail, Halaçli Burçin, Güven Göksel, Bilir Yeliz, Civan Yüksel Recep, Özyilmaz Ezgi, Altintaş Neriman Defne, Ferliçolak Leyla, Aydin Emre, Akbaş Türkay, Esbah Ali Ümit, Güllü Zuhal, Inci Kamil, Elay Gülseren, Topeli Arzu, Gündoğan Kürşat
Format: Article
Language:English
Published: Society of Medical Biochemists of Serbia, Belgrade 2025-01-01
Series:Journal of Medical Biochemistry
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Online Access:https://scindeks-clanci.ceon.rs/data/pdf/1452-8258/2025/1452-82582502330T.pdf
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author Temel Şahin
Hanci Pervin
Hakkı Akbudak Ismail
Halaçli Burçin
Güven Göksel
Bilir Yeliz
Civan Yüksel Recep
Özyilmaz Ezgi
Altintaş Neriman Defne
Ferliçolak Leyla
Aydin Emre
Akbaş Türkay
Esbah Ali Ümit
Güllü Zuhal
Inci Kamil
Elay Gülseren
Topeli Arzu
Gündoğan Kürşat
author_facet Temel Şahin
Hanci Pervin
Hakkı Akbudak Ismail
Halaçli Burçin
Güven Göksel
Bilir Yeliz
Civan Yüksel Recep
Özyilmaz Ezgi
Altintaş Neriman Defne
Ferliçolak Leyla
Aydin Emre
Akbaş Türkay
Esbah Ali Ümit
Güllü Zuhal
Inci Kamil
Elay Gülseren
Topeli Arzu
Gündoğan Kürşat
author_sort Temel Şahin
collection DOAJ
description Background: Despite a lack of sufficient knowledge about the prevalence and impact of hypophosphatemia in critically ill COVID-19 patients, organ dysfunction, adverse clinical outcomes, and increased mortality have been consistently associated with hypophosphatemia across diverse patient populations. This retrospective, observational study aimed to investigate hypophosphatemia (HypoP) frequency and establish the correlation between variations in serum phosphorus levels and outcomes in critically ill patients with SARS-CoV-2. Methods: The research comprised 205 patients diagnosed with COVID-19 confirmed via RT-PCR. The study included COVID-19 patients who experienced respiratory failure and were in intensive care for more than 24 hours, and their phosphorus values were accurately documented. Clinical para meters, comorbidities, respiratory support requirements, and laboratory findings were analysed. Results: The study participants had a median age of 64 (IQR: 54-75 years), with hypertension being the most pre - valent chronic disease (46%). During the first three days of intensive care, 33% of the participants received conventional oxygen support, whereas 54% required intubation and mechanical ventilation (MV). During this period, hypophosphatemia was noted in 25% of patients, with an ICU admission median serum phosphorus level of 1.02 (0.87-1.25) mmol/L. The median duration of stay in the intensive care unit (ICU) was 7 days, significantly extended in patients with hypophosphatemia (p=0.046). Phosphorus levels on the third day of ICU stay were an independent predictor of ICU mortality. (COX, HR=1.48, 95% CI=1.11-1.98, p=0.006) Conclusions: During the first three days of ICU admission, 25% of SARS-CoV-2 critically ill adult patients presented with hypophosphatemia. This condition was found to increase ICU mortality rates and prolong ICU stays. Therefore, it is crucial to monitor serum phosphorus levels in the care of critically ill COVID-19 patients.
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spelling doaj-art-c5bfcfd65c144d3886229d0615b83cbe2025-08-20T03:06:57ZengSociety of Medical Biochemists of Serbia, BelgradeJournal of Medical Biochemistry1452-82581452-82662025-01-0144233033810.5937/jomb0-524741452-82582502330THypophosphatemia: Unraveling a lethal connection with icu mortality in critically ill COVID-19 patients: a multicenter observational studyTemel Şahin0Hanci Pervin1Hakkı Akbudak Ismail2Halaçli Burçin3Güven Göksel4Bilir Yeliz5Civan Yüksel Recep6Özyilmaz Ezgi7Altintaş Neriman Defne8Ferliçolak Leyla9Aydin Emre10Akbaş Türkay11Esbah Ali Ümit12Güllü Zuhal13Inci Kamil14Elay Gülseren15Topeli Arzu16Gündoğan Kürşat17Erciyes University, School of Medicine, Department of Internal Medicine, Division of Intensive Care Medicine, Kayseri, TurkeyTrakya University, School of Medicine, Department of Chest Diseases, Division of Intensive Care Medicine, Edirne, TurkeyPamukkale University, School of Medicine, Department of Internal Medicine, Division of Intensive Care Medicine, Denizli, TurkeyHacettepe University, School of Medicine, Department of Internal Medicine, Division of Intensive Care Medicine, Ankara, TurkeyHacettepe University, School of Medicine, Department of Internal Medicine, Division of Intensive Care Medicine, Ankara, TurkeyMinistry of Health, Istanbul Lütfi Kırdar Training and Research Hospital, Intensive Unit, Istanbul, TurkeyErciyes University, School of Medicine, Department of Internal Medicine, Division of Intensive Care Medicine, Kayseri, TurkeyÇukurova University School of Medicine, Department of Chest Diseases, Division of Intensive Care Medicine, Adana, TurkeyAnkara University School of Medicine, Department of Internal Medicine, Division of Intensive Care Medicine, Ankara, TurkeyAnkara University School of Medicine, Department of Internal Medicine, Division of Intensive Care Medicine, Ankara, TurkeyDicle University School of Medicine, Department of Internal Medicine, Division of Intensive Care Medicine, Diyarbakır, TurkeyDüzce University School of Medicine, Department of Internal Medicine, Division of Intensive Care Medicine, Düzce, TurkeyDüzce University School of Medicine, Department of Internal Medicine, Division of Intensive Care Medicine, Düzce, TurkeyAnkara Yenimahalle Training and Research Hospital, Intensive Care Unit, Ministry of Health, Ankara, TurkeyAnkara Yenimahalle Training and Research Hospital, Intensive Care Unit, Ministry of Health, Ankara, TurkeyGaziantep University, School of Medicine, Department of Internal Medicine, Division of Intensive Care Medicine, Gaziantep, TurkeyHacettepe University, School of Medicine, Department of Internal Medicine, Division of Intensive Care Medicine, Ankara, TurkeyErciyes University, School of Medicine, Department of Internal Medicine, Division of Intensive Care Medicine, Kayseri, TurkeyBackground: Despite a lack of sufficient knowledge about the prevalence and impact of hypophosphatemia in critically ill COVID-19 patients, organ dysfunction, adverse clinical outcomes, and increased mortality have been consistently associated with hypophosphatemia across diverse patient populations. This retrospective, observational study aimed to investigate hypophosphatemia (HypoP) frequency and establish the correlation between variations in serum phosphorus levels and outcomes in critically ill patients with SARS-CoV-2. Methods: The research comprised 205 patients diagnosed with COVID-19 confirmed via RT-PCR. The study included COVID-19 patients who experienced respiratory failure and were in intensive care for more than 24 hours, and their phosphorus values were accurately documented. Clinical para meters, comorbidities, respiratory support requirements, and laboratory findings were analysed. Results: The study participants had a median age of 64 (IQR: 54-75 years), with hypertension being the most pre - valent chronic disease (46%). During the first three days of intensive care, 33% of the participants received conventional oxygen support, whereas 54% required intubation and mechanical ventilation (MV). During this period, hypophosphatemia was noted in 25% of patients, with an ICU admission median serum phosphorus level of 1.02 (0.87-1.25) mmol/L. The median duration of stay in the intensive care unit (ICU) was 7 days, significantly extended in patients with hypophosphatemia (p=0.046). Phosphorus levels on the third day of ICU stay were an independent predictor of ICU mortality. (COX, HR=1.48, 95% CI=1.11-1.98, p=0.006) Conclusions: During the first three days of ICU admission, 25% of SARS-CoV-2 critically ill adult patients presented with hypophosphatemia. This condition was found to increase ICU mortality rates and prolong ICU stays. Therefore, it is crucial to monitor serum phosphorus levels in the care of critically ill COVID-19 patients.https://scindeks-clanci.ceon.rs/data/pdf/1452-8258/2025/1452-82582502330T.pdfsars-cov-2hypophosphatemiaintensive care unitrespiratory failurecritical care
spellingShingle Temel Şahin
Hanci Pervin
Hakkı Akbudak Ismail
Halaçli Burçin
Güven Göksel
Bilir Yeliz
Civan Yüksel Recep
Özyilmaz Ezgi
Altintaş Neriman Defne
Ferliçolak Leyla
Aydin Emre
Akbaş Türkay
Esbah Ali Ümit
Güllü Zuhal
Inci Kamil
Elay Gülseren
Topeli Arzu
Gündoğan Kürşat
Hypophosphatemia: Unraveling a lethal connection with icu mortality in critically ill COVID-19 patients: a multicenter observational study
Journal of Medical Biochemistry
sars-cov-2
hypophosphatemia
intensive care unit
respiratory failure
critical care
title Hypophosphatemia: Unraveling a lethal connection with icu mortality in critically ill COVID-19 patients: a multicenter observational study
title_full Hypophosphatemia: Unraveling a lethal connection with icu mortality in critically ill COVID-19 patients: a multicenter observational study
title_fullStr Hypophosphatemia: Unraveling a lethal connection with icu mortality in critically ill COVID-19 patients: a multicenter observational study
title_full_unstemmed Hypophosphatemia: Unraveling a lethal connection with icu mortality in critically ill COVID-19 patients: a multicenter observational study
title_short Hypophosphatemia: Unraveling a lethal connection with icu mortality in critically ill COVID-19 patients: a multicenter observational study
title_sort hypophosphatemia unraveling a lethal connection with icu mortality in critically ill covid 19 patients a multicenter observational study
topic sars-cov-2
hypophosphatemia
intensive care unit
respiratory failure
critical care
url https://scindeks-clanci.ceon.rs/data/pdf/1452-8258/2025/1452-82582502330T.pdf
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