• Crit Care · Oct 2022

    Multicenter Study

    Dehydration is associated with production of organic osmolytes and predicts physical long-term symptoms after COVID-19: a multicenter cohort study.

    • Michael Hultström, Miklos Lipcsey, Dave R Morrison, Tomoko Nakanishi, Guillaume Butler-Laporte, Yiheng Chen, Satoshi Yoshiji, Vincenzo Forgetta, Yossi Farjoun, Ewa Wallin, Ing-Marie Larsson, Anders Larsson, Adriana Marton, Jens Marc Titze, Sandra Nihlén, J Brent Richards, and Robert Frithiof.
    • Anaesthesiology and Intensive Care Medicine, Department of Surgical Sciences, Uppsala University, Akademiska Sjukhuset, ANOPIVA, Ing70, 2Tr, 75185, Uppsala, Sweden. michael.hultstrom@mcb.uu.se.
    • Crit Care. 2022 Oct 21; 26 (1): 322.

    BackgroundWe have previously shown that iatrogenic dehydration is associated with a shift to organic osmolyte production in the general ICU population. The aim of the present investigation was to determine the validity of the physiological response to dehydration known as aestivation and its relevance for long-term disease outcome in COVID-19.MethodsThe study includes 374 COVID-19 patients from the Pronmed cohort admitted to the ICU at Uppsala University Hospital. Dehydration data was available for 165 of these patients and used for the primary analysis. Validation was performed in Biobanque Québécoise de la COVID-19 (BQC19) using 1052 patients with dehydration data. Dehydration was assessed through estimated osmolality (eOSM = 2Na + 2 K + glucose + urea), and correlated to important endpoints including death, invasive mechanical ventilation, acute kidney injury, and long COVID-19 symptom score grouped by physical or mental.ResultsIncreasing eOSM was correlated with increasing role of organic osmolytes for eOSM, while the proportion of sodium and potassium of eOSM were inversely correlated to eOSM. Acute outcomes were associated with pronounced dehydration, and physical long-COVID was more strongly associated with dehydration than mental long-COVID after adjustment for age, sex, and disease severity. Metabolomic analysis showed enrichment of amino acids among metabolites that showed an aestivating pattern.ConclusionsDehydration during acute COVID-19 infection causes an aestivation response that is associated with protein degradation and physical long-COVID.Trial RegistrationThe study was registered à priori (clinicaltrials.gov: NCT04316884 registered on 2020-03-13 and NCT04474249 registered on 2020-06-29).© 2022. The Author(s).

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…