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  • Hultström, Michael,1978-Uppsala universitet,Anestesiologi och intensivvård,Integrativ Fysiologi,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.;Lady Davis Institute of Medical Research, Jewish General Hospital, McGill University, Montreal, QC, Canada. (author)

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

  • Article/chapterEnglish2022

Publisher, publication year, extent ...

  • 2022-10-21
  • Springer Nature,2022
  • electronicrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-487057
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-487057URI
  • https://doi.org/10.1186/s13054-022-04203-wDOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • BACKGROUND: We 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.METHODS: The 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.RESULTS: Increasing 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.CONCLUSIONS: Dehydration during acute COVID-19 infection causes an aestivation response that is associated with protein degradation and physical long-COVID.TRIAL REGISTRATION: The study was registered à priori (clinicaltrials.gov: NCT04316884 registered on 2020-03-13 and NCT04474249 registered on 2020-06-29).

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  • Lipcsey, MiklósUppsala universitet,Hedenstiernalaboratoriet(Swepub:uu)milip123 (author)
  • Morrison, Dave RLady Davis Institute of Medical Research, Jewish General Hospital, McGill University, Montreal, QC, Canada. (author)
  • Nakanishi, TomokoLady Davis Institute of Medical Research, Jewish General Hospital, McGill University, Montreal, QC, Canada. (author)
  • Butler-Laporte, GuillaumeLady Davis Institute of Medical Research, Jewish General Hospital, McGill University, Montreal, QC, Canada. (author)
  • Chen, YihengLady Davis Institute of Medical Research, Jewish General Hospital, McGill University, Montreal, QC, Canada. (author)
  • Yoshiji, SatoshiLady Davis Institute of Medical Research, Jewish General Hospital, McGill University, Montreal, QC, Canada. (author)
  • Forgetta, VincenzoLady Davis Institute of Medical Research, Jewish General Hospital, McGill University, Montreal, QC, Canada. (author)
  • Farjoun, YossiLady Davis Institute of Medical Research, Jewish General Hospital, McGill University, Montreal, QC, Canada. (author)
  • Wallin, EwaUppsala universitet,Anestesiologi och intensivvård(Swepub:uu)ewawa635 (author)
  • Larsson, Ing-Marie,1963-Uppsala universitet,Anestesiologi och intensivvård(Swepub:uu)ingla697 (author)
  • Larsson, AndersUppsala universitet,Klinisk kemi(Swepub:uu)andlarss (author)
  • Marton, AdrianaProgram in Cardiovascular and Metabolic Disorders, Duke- NUS Medical School, Singapore, Singapore. (author)
  • Titze, Jens MarcProgram in Cardiovascular and Metabolic Disorders, Duke- NUS Medical School, Singapore, Singapore. (author)
  • Nihlén, SandraUppsala universitet,Anestesiologi och intensivvård(Swepub:uu)sanho907 (author)
  • Richards, J BrentDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada. (author)
  • Frithiof, RobertUppsala universitet,Anestesiologi och intensivvård(Swepub:uu)robfr118 (author)
  • Uppsala universitetAnestesiologi och intensivvård (creator_code:org_t)

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  • In:Critical Care: Springer Nature261364-85351466-609X

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