Abstract

Background: Electrolyte imbalances are common in COVID-19 infection and are associated with poor outcomes in hospitalized patients. Objectives: This study examined whether serum phosphate imbalances at admission are associated with mortality in hospitalized COVID-19 patients. Methods: In this registry-based single-center retrospective cohort study, 1349 inpatients with COVID-19 were included from March 2020 to March 2021 in an academic hospital in Ilam (southwest Iran). The Cox proportional hazard (PH) regression model was ap-plied to the data set of COVID-19. Results: The in-hospital median survival time for patients with low, normal, and high serum phosphate levels was 14, 25, and 8 days, respectively. In a multivariate model, adjusted for the other variables, patients with hypophosphatemia (adjusted hazard ratio HR, 2.53; 95% CI, 1.15-5.58; P = 0.02) and hyperphosphatemia (adjusted HR, 1.77; 95% CI, 1.00-3.14; P = 0.05) had an increased mortality hazard compared with those who had normal levels of serum phosphate. Conclusions: Our results demonstrate a strong effect of hypophosphatemia and hyperphosphatemia with increased in-hospital mortality in COVID-19 patients. Intensive medical care and more attention must be paid to COVID-19 patients with serum phosphate imbalances at admission. © 2022, International Journal of Endocrinology and Metabolism.