Postassium/hypokalemia, and COVID-19 cardiac issues

[Mary]

Hypokalemia caused by COVID-19 may be the cause of cardiac issues found in COVID-19 patients. @Sushi , tagging you here FYI -

https://www.medrxiv.org/content/10.1101/2020.02.27.20028530v1

SARS-CoV-2 has caused a series of COVID-19 globally. SARS-CoV-2 binds angiotensin I converting enzyme 2 (ACE2) of renin-angiotensin system (RAS) and causes prevalent hypokalemia

Body temperature, CK, CK-MB, LDH, and CRP were significantly associated with the severity of hypokalemia (P<0.01). 93% of severe and critically ill patients had hypokalemia which was most common among elevated CK, CK-MB, LDH, and CRP. Urine K+ loss was the primary cause of hypokalemia. severe hypokalemia patients was given 3 g/day, adding up to an average of 34 (SD=4) g potassium during hospital stay. The exciting finding was that patients responded well to K+ supplements when they were inclined to recovery.

https://www.consumerlab.com/answers...ntent=astragalus_non_member_de_send#potassium

Hypokalemia can cause heart dysfunction, one of the major problems seen in COVID-19. High levels of markers of heart muscle damage were associated with more severe hypokalemia. The presence of underlying disease, particularly hypertension, was associated with the severity of hypokalemia. On the other hand, there was no association with hypokalemia with common upper respiratory symptoms, such as cough and runny nose (i.e., if those are your only symptoms, you probably don't have to worry about your potassium level.) (Chen, preprint in medRxiv 2020 -- Not yet peer-reviewed).

 

[Sushi]

Hypokalemia can cause heart dysfunction, one of the major problems seen in COVID-19.

Forums on Afib and other arrhythmias are discussing this too as low potassium can trigger an arrhythmia even in someone who does not have a history of it. Arrythmias have occurred in many COVID-19 patients (sorry I don't have the percentage at hand), and these have been one of the more serious complications. They are now finding that cardiac complications are as common as pulmonary complications and

SARS-CoV-2 has caused a series of COVID-19 globally. SARS-CoV-2 binds angiotensin I converting enzyme 2 (ACE2) of renin-angiotensin system (RAS) and causes prevalent hypokalemia

could certainly be one of the causes.

 

[Gingergrrl]

Tagging @Inara into this thread as we were discussing this earlier. @Sushi Are people in your Afib forum saying that taking Potassium is protective against catching COVID-19 or only helpful after getting it?

I take 20 MEQ of Potassium every night b/c my Potassium runs low on tests without it. I do not have Afib but have history of POTS and Inappropriate Sinus Tachy (IST) in the past.

 

[Sushi]

Are people in your Afib forum saying that taking Potassium is protective against catching COVID-19 or only helpful after getting it?

They are discussing potassium only in relation to arrhythmias. I have not read any evidence that it is protective against COVID-19 other than the protection of having a good nutritional status, but, if you get the virus, potassium supplementation could be protective against the lowering of potassium (and hence the risk of arrhythmias) as described in the opening post.

 

[Gingergrrl]

They are discussing potassium only in relation to arrhythmias. I have not read any evidence that it is protective against COVID-19 other than the protection of having a good nutritional status, but, if you get the virus, potassium supplementation could be protective against the lowering of potassium (and hence the risk of arrhythmias) as described in the opening post.

Thank you and that is exactly what I was trying to figure out. I hope there isn't going to be a Potassium shortage like there is with everything else that gets linked to COVID-19. I just switched two of my other meds to 3-month supplies and am now wondering if I should do this with my Potassium, too?

 

[Mary]

Thank you and that is exactly what I was trying to figure out. I hope there isn't going to be a Potassium shortage like there is with everything else that gets linked to COVID-19. I just switched two of my other meds to 3-month supplies and am now wondering if I should do this with my Potassium, too?

I think it would be good to switch to a 3-month supply of potassium, not because of a possible shortage, but because of possible problems getting prescriptions filled if too many people get sick. e.g., I had a 3-month mail-order prescription that Costco was going to fill - due to COVID-19, it was going to take them 3 to 4 weeks to fill it. which would have been fine, I had enough of my med to last me that long. But all I could think was, what will things be like in 3 to 4 weeks? Will Costco have enough staff to fill prescriptions then, etc. So I got it elsewhere in a few days and paid more for it, but don't have to worry about it now.

I don't think the general public is going to stock up on potassium like they did with toilet paper, but certainly medical providers will need more of it in treating COVID-19 patients. Who knows what's going to happen! I'd get a 3-month supply for your own peace of mind!

 

[Sushi]

I hope there isn't going to be a Potassium shortage like there is with everything else that gets linked to COVID-19.

Here is the substitution that many cardiac patients use--low sodium V8 or low sodium Very Veggie--they use potassium to replace salt:

NUTRITION FACTS
Serving Size
8 OZ (240 mL)
Potassium 850mg

So if you drink a few glasses during the day you get a whopping dose of potassium in a safe manner.

 

[ebethc]

Inappropriate Sinus Tachy (IST) in the past.

what is IST?

 

[Gingergrrl]

what is IST?

IST is just the abbreviation for inappropriate sinus tachycardia. If you Google it, there is a lot of info. It means that you are having inappropriate tachycardia (not triggered by exercise, anxiety, or anything that should cause tachy) BUT all of the tachy is in normal sinus rhythm and you are not having Afib or any type of arrhythmia. In my case, once I was diagnosed with POTS, it was unclear whether I truly ever had an IST diagnosis at all and that it was all due to undiagnosed POTS. Hope this helps.

 

[L'engle]

@Gingergrrl From my perspective I would say stock up a bit on any electrolytes you might need. For me I've had trouble ordering powdered potassium to Canada because of our new restrictions in the last year. There probably won't be a run on it, but you never know. I stocked up on epsom salts and a smaller amount of powdered potassium. Also I never know when something will cause me to need more of it so I like to have it around.

 

[Gingergrrl]

I think it would be good to switch to a 3-month supply of potassium

@Gingergrrl From my perspective I would say stock up a bit on any electrolytes you might need.

Thank you guys and I agree and am going to switch my Potassium to a 3-month prescription for the next time I refill it. I have a call w/my doctor early next week re: other issues and am certain he will be fine with this. I keep trying to stock up on things and then realize how many things are not on my list. It is endless!

Edit: I just sent a msg to my doctor's office re: changing my Potassium to a 3-month prescription so I don't even have to waste time on the phone call re: this issue b/c I have more important questions to discuss.