| Coronavirus disease 2019 (COVID-19) is a catastrophic contagious
disease caused by severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2). Electrolyte disturbances are common complications of
COVID-19. The present article examined the potential mechanisms
of hypokalemia and hyperkalemia in patients suffering from
COVID-19, in order to raise awareness of potassium disorders in
SARS-CoV-2 infections. PubMed, Scopus, and Google Scholar were
searched with keywords, such as “COVID-19”, “SARS-CoV-2”,
“2019-nCoV”, “Hypokalemia”, “Hyperkalemia”, “Serum potassium”,
and “Etiology”, “Pathophysiology” up to April 20, 2021 without
any search filters. We included articles that proposed potential
mechanisms for potassium abnormalities in COVID-19 patients.
Furthermore, we used backward and forward citation searching.
Potassium abnormalities are considered to be important electrolyte
disturbances, with reported incidences ranging from < 5% to > 50%
in patients affected by SARS-CoV-2. Therefore, understanding the
etiologies of potassium abnormalities could help to improve disease
outcome. Utilization of ACE2 by SARS-CoV-2 in the renal cells,
viral-induced tubular injury, and gastrointestinal abnormalities,
such as anorexia, diarrhea, and vomiting may predispose COVID-19
patients to developing hypokalemia. Furthermore, depleted
magnesium levels make hypokalemia refractory to treatments.
In addition, hyperkalemia may occur because of reduced urinary
output, as a consequence of renal failure. Changes in blood pH
and medication-induced side-effects are other possible reasons
for the deviation of potassium levels from the normal range.
The etiology of potassium abnormalities in COVID-19 patients is
multifactorial. Therefore, the early detection and management of
potassium disorders is vital and would improve the outcome of
patients with COVID-19. |