Mo870hypochloremia is associated with a greater incidence of pneumonia in chronic hemodialysis patients with covid-19: a center's experience

Abstract Background and Aims Recently, serum chloride has gained greater importance in the assessment of patients with heart failure and sepsis. Hypochloremia has been associated with higher mortality. On the other hand, COVID-19 pandemic continues to be, to date, a threat to public health. Patients with cardiovascular comorbidity or chronic kidney disease are particularly vulnerable. There are some studies that show a trend towards a lower serum chloride concentration in patients with a positive PCR test for SARS-CoV-2. Therefore, the objective of our study was to determine if there is a relationship between serum chloride levels at the time of diagnosis and a greater tendency to develop COVID-19 pneumonia in chronic hemodialysis patients. Method Retrospective cohort study. We analyzed the serum chloride, C-reactive protein (CRP), procalcitonin, neutrophil-lymphocyte (NLR) and platelet-lymphocyte (PLR) ratios of 11 chronic hemodialysis patients with a positive SARS-CoV-2 TMA PCR test during the second wave of the pandemic in our hospital (August-December 2020). We collected the length of hospital stay, the diagnosis of pneumonia (yes/no) and the final state of the infection (cure or death). The patients were divided into two groups taking the median serum chloride as the cut-off point (1: <97 mEq / L and 2:> 97mEq / L) Results The mean age was 57 ± 13 years and 36.36% (N = 4) were women. All patients required hospital admission and mean hospitalization time was 19 ± 13 days. 3 patients (27.3%) died. The medians of the parameters were the following: serum chloride 97 mEq / L (IQR 94-99); CRP 29.04 mg / L (IQR 8.53-76.13); NLR 4.13 (IQR 2.67-8.48) and PLR 244.06 (IQR 208.08-320). 81.8% (N = 9) had COVID-19 pneumonia. Group 1 patients (Chloride <97 mEL / L) had a higher incidence of pneumonia (p = 0.049) (Figure 1) and a greater tendency to be admitted to the Intensive Care Unit (ICU) (p = 0.029). Despite not reaching statistical significance, there was also a higher mortality in patients with lower chloride levels.MO870   Figure 1: Chloride levels and diagnosis of COVID-19 pneumonia in chronic hemodialysis patients Conclusion Chronic hemodialysis patients with SARS-CoV-2 infection and lower serum chloride levels at hospital admission were more likely to develop pneumonia.