DOI: https://doi.org/10.53350/pjmhs2216637 ORIGINAL ARTICLE P J M H S Vol. 16, No. 06, Jun 2022 37 Association of Respiratory Tract Infections causing Alterations in Lung Parenchyma and Pulmonary Vasculature with Body Electrolyte Imbalance SADIA ZIA 1 , YASIR ALI BHATTI 2 , NABEELA HABIB 3 , ZULFIQAR ALI 4 , AFSHEEN AKBAR 5 , BEENISH SOHAIL 6 1 Assistant Professor Pathology, Avicenna Medical College Lahore 2 Associate Professor Biochemistry, Avicenna Medical College Lahore 3 AssociateProfessor Anatomy, Avicenna Medical College Lahore 4 Associte Professor of Pathology, Avicenna Medical College Lahore 5 Associate Professor Physiology, Avicenna Medical College Lahore 6 Lecturer Physiology, Avicenna Medical College Lahore Correspondence to Dr. Sadia Zia, Email: sadiazia725@gmail.com Mobile: 03238323323 ABSTRACT Aim: The assessment of serum electrolytes at the time of initial presentation of the patient with respiratory tract infection possibly causing lung parenchyma and pulmonary vasculature damage and serial monitoring during the stay could be beneficial in order to determine when and how to take remedial action when necessary. Methodology: A non-probability sampling was done on 139 subjects with suspected respiratory tract infection. For confirmation, culture, MTB PCR, COVID-19 testing was done to diagnose the nature of infection. Serum electrolytes were tested on chemical analyses Alinity instrument. Results: Most common infections found were COVID-19 and bacterial (n=59) collectively in a co-morbid state. Mycobacterium tuberculosis and fungal infections were also found in (n=8) each. Electrolytes imbalance was markedly observed in high prevalence amongst Tuberculosis and COVID-19 patients but also showed significant association with other respiratory investigated infections. Conclusion: A robust association of electrolyte imbalance was found in all cases presented with upper or lower respiratory tract infections. Keywords: Respiratory tract infections, electrolyte imbalance, Covid-19, MTB, Sodium, Potassium INTRODUCTION Respiratory infections are a significant cause of illness and mortality in the developing world, and their prevalence is increasing, particularly with chronic respiratory disease 1 . Numerous demographic, clinical, and laboratory variables are associated with respiratory infection prognosis and severity 2 . The most common co-morbidities related with illness severity are hypertension and diabetes mellitus. Similarly, decreased lymphocyte, increased serum ferritin and platelet counts; interleukin-10 (IL-10) levels and interleukin-6 (IL-6); abnormal coagulation parameters such as increased D-dimer levels; alterations in cardiac and muscle injury parameters; and abnormal liver and kidney function biomarkers were all associated with severe disease and poor outcome in lower and upper respiratory tract infection 3 . On the other hand, numerous acute and chronic adult respiratory illnesses have been increasing in prevalence throughout the world. Acute diseases such as pneumonia and influenza are classified as acute; chronic diseases such as chronic obstructive pulmonary disease (COPD) and asthma are classified as chronic; occupational lung diseases such as byssinosis, asbestosis, and coal worker's pneumoconiosis are classified as occupational lung diseases; and other parenchymal lung diseases such as immune-related lung diseases are classified as chronic 4 . But each year, respiratory diseases alone, primarily pneumonia and influenza, claim approximately 4 million lives globally. They are the top causes of disease and death among children under the age of five. Acute respiratory infections are responsible for at least 6% of global disability and death and for 20% to 40% of all pediatric hospitalizations 3,14 . The death rate from acute respiratory infections alone is tenfold that of the worldwide median death rate from all causes in portions of the developing world 5 . Tuberculosis (TB) caused by Mycobacterium has a major part of respiratory infection 6 . According to WHO 2013 projections, eliminating the disease by 2050 would require a substantial increase to at least a 15% yearly decline in cases. Although the pipeline for new medications is longer than it has been in decades and a new antibiotic, bed ------------------------+--------------------------------------------------------------- Received on 19-11-2021 Accepted on 09-05-2022 aquiline, has been approved for use in the treatment of multidrug- resistant tuberculosis, many novel compounds will be required to effect a paradigm shift in how tuberculosis is treated. Additionally, the global spread of multidrug-resistant tuberculosis jeopardizes global TB control efforts and jeopardizes the lives of hundreds of thousands of individuals 6,7 . The order of additional confirmation by bacterial culture, molecular testing, and imaging is dictated by the differential diagnosis of respiratory infections, which is primarily based on physical examination and history. For the objective of swiftly diagnosing any potentially life-threatening respiratory conditions (multi-lobar pneumonia, tuberculosis), multiple additional tests are typically undertaken at the same time. On the other side, coughing and long-term dyspnea may be beneficial. There was some renal involvement in people with respiratory infections or a long hospital stay in some cases. Patients with respiratory tract infections are more likely to experience acute kidney damage, electrolyte abnormalities and hematuria as renal involvement. However, none of the studies included in this review particularly examined the status of electrolyte imbalances and their impact on survival and illness severity in connection with lung infection and found that lower sodium, potassium, and calcium levels were associated with severe disease. This study has focused on any disturbance in electrolyte imbalance during respiratory infection which will help prognosis of upper and lower respiratory tract infection. The objective of the study was to correlate serum electrolytes such as serum sodium, chloride, potassium, calcium and magnesium levels in subjects with upper and lower respiratory tract infections. MATERIALS & METHODOLOGY This was a cross-sectional descriptive study which was conducted on patients visited a tertiary care hospital pulmonology department after permission from Ethical Review Board. Sample collection: Non probability sampling technique was used for recruitment of patients, 139 patients were selected with suspected respiratory tract infection. Demographic features (Gender and age), Infection type (Upper respiratory, lower respiratory), culture of sputum for confirmation infection type either bacterial or viral, GeneXpert for