Predictors and outcome of hyponatremia in patients with COVID 19: a single-center experience

Year 2022, Volume: 5 Issue: 3, 799 - 804, 30.05.2022

Ercan Türkmen , Mahmut Altındal , Ferah Taran , Tuba Kuruoğlu , Aydın Deveci , Melih Akpunar , Seyyid Bilal Açıkgöz , Nurhan Köksal

https://doi.org/10.32322/jhsm.1080704

Abstract

Introduction/Aim: Hyponatremia (serum sodium <135 mEq/L) portends a worse prognosis in patients with community-acquired pneumonia. Data regarding the outcome of hyponatremia in hospitalized COVID-19 patients are insufficient and controversial. The present study aimed to identify the predictors of hyponatremia and its impact on clinical outcome measures in hospitalized COVID-19 patients.
Material and Method: We conducted a retrospective study on 787 adult patients with SARS-CoV-2 infection admitted to a university hospital between March 10, 2020, and December 15, 2020, February. Demographic and laboratory features, comorbid diseases, medications, radiology results, and clinical outcome measures of the patients were obtained retrospectively from their medical records.
Findings: One hundred fifty-nine (20.2%) patients out of 787 had hyponatremia. Hyponatremia was mild (sodium: 130 -134 mEq/L) in majority of cases (n=124). The severity of pneumonia (p = 0.013) and having diabetes (p > 0.001) were the independent predictors of hyponatremia at the time of admission. The median length of hospital stay (LOS) was longer in patients with hyponatremia than patients with normonatremia (10 days vs. 8 days, p < 0.001). In multivariate analysis, hyponatremia was significantly associated with ICU admission or the need for mechanical ventilation (adjusted OR, 1.72; 95% confidence interval [95% CI], 1.03 to 2.85; p = 0.036). The severity of pneumonia, hemoglobin and lactate dehydrogenase levels, neutrophil-to-lymphocyte ratio (NLR), and body temperature were also associated with ICU admission or the need for mechanical ventilation. The oxygen saturation, male sex, serum albumin, NLR, and the ICU admission but not the hyponatremia on admission were significantly related to mortality.
Conclusion: Hyponatremia on admission, even when mild, predicts a worse outcome in COVID-19 patients, and it should be considered in risk stratification.

Keywords

Hyponatremia, COVID-19, outcomes

Supporting Institution

None

Thanks

None

References

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