Article ; Online: Prevalence and outcome of dysnatremia in patients with COVID-19 compared to controls.
European journal of endocrinology
2021 Volume 184, Issue 3, Page(s) 409–418
Abstract: ... a cox proportional hazard model.: Results: 172 (17%) cases with COVID-19 and 849 (83%) controls were included. Patients ... measures to be taken for patients with COVID-19 and dysnatremia. ... Therefore, we investigated the prevalence and outcome of dysnatremia in COVID-19.: Design: The prospective, observational ...
| Abstract | Objective: The pandemic of coronavirus disease (COVID-19) has rapidly spread globally and infected millions of people. The prevalence and prognostic impact of dysnatremia in COVID-19 is inconclusive. Therefore, we investigated the prevalence and outcome of dysnatremia in COVID-19. Design: The prospective, observational, cohort study included consecutive patients with clinical suspicion of COVID-19 triaged to a Swiss Emergency Department between March and July 2020. Methods: Collected data included clinical, laboratory and disease severity scoring parameters on admission. COVID-19 cases were identified based on a positive nasopharyngeal swab test for SARS-CoV-2, patients with a negative swab test served as controls. The primary analysis was to assess the prognostic impact of dysnatremia on 30-day mortality using a cox proportional hazard model. Results: 172 (17%) cases with COVID-19 and 849 (83%) controls were included. Patients with COVID-19 showed a higher prevalence of hyponatremia compared to controls (28.1% vs 17.5%, P < 0.001); while comparable for hypernatremia (2.9% vs 2.1%, P = 0.34). In COVID-19 but not in controls, hyponatremia was associated with a higher 30-day mortality (HR: 1.4, 95% CI: 1.10-16.62, P = 0.05). In both groups, hypernatremia on admission was associated with higher 30-day mortality (COVID-19 - HR: 11.5, 95% CI: 5.00-26.43, P < 0.001; controls - HR: 5.3, 95% CI: 1.60-17.64, P = 0.006). In both groups, hyponatremia and hypernatremia were significantly associated with adverse outcome, for example, intensive care unit admission, longer hospitalization and mechanical ventilation. Conclusion: Our results underline the importance of dysnatremia as predictive marker in COVID-19. Treating physicians should be aware of appropriate treatment measures to be taken for patients with COVID-19 and dysnatremia. |
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| MeSH term(s) | Adult ; Aged ; COVID-19/complications ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19/therapy ; Case-Control Studies ; Cohort Studies ; Critical Care/statistics & numerical data ; Female ; Hospital Mortality ; Hospitalization/statistics & numerical data ; Humans ; Hypernatremia/complications ; Hypernatremia/diagnosis ; Hypernatremia/epidemiology ; Hypernatremia/therapy ; Hyponatremia/complications ; Hyponatremia/diagnosis ; Hyponatremia/epidemiology ; Hyponatremia/therapy ; Length of Stay/statistics & numerical data ; Male ; Middle Aged ; Mortality ; Pandemics ; Prevalence ; Prognosis ; Prospective Studies ; SARS-CoV-2 ; Switzerland/epidemiology ; Triage | |||||
| Language | English | |||||
| Publishing date | 2021-01-15 | |||||
| Publishing country | England | |||||
| Document type | Journal Article ; Observational Study | |||||
| ZDB-ID | 1183856-5 | |||||
| ISSN | 1479-683X ; 0804-4643 | |||||
| ISSN (online) | 1479-683X | |||||
| ISSN | 0804-4643 | |||||
| DOI | 10.1530/EJE-20-1374 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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