Dysnatremia is a Predictor for Morbidity and Mortality in Hospitalized Patients with COVID-19.

Autor:	Tzoulis P; Department of Metabolism & Experimental Therapeutics, Division of Medicine, University College London, London, UK.; Department of Endocrinology & Diabetes, Whittington Health NHS Trust, London, UK., Waung JA; Department of Endocrinology & Diabetes, Whittington Health NHS Trust, London, UK., Bagkeris E; National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK., Hussein Z; Department of Diabetes & Endocrinology, University College London Hospital NHS Foundation Trust, London, UK.; Division of Medicine, University College London, London, UK., Biddanda A; Department of Endocrinology & Diabetes, Whittington Health NHS Trust, London, UK., Cousins J; Department of Endocrinology & Diabetes, Whittington Health NHS Trust, London, UK., Dewsnip A; Department of Endocrinology & Diabetes, Whittington Health NHS Trust, London, UK., Falayi K; Department of Endocrinology & Diabetes, Whittington Health NHS Trust, London, UK., McCaughran W; Department of Endocrinology & Diabetes, Whittington Health NHS Trust, London, UK., Mullins C; Department of Endocrinology & Diabetes, Whittington Health NHS Trust, London, UK., Naeem A; Department of Endocrinology & Diabetes, Whittington Health NHS Trust, London, UK., Nwokolo M; Department of Endocrinology & Diabetes, Whittington Health NHS Trust, London, UK., Quah H; Department of Endocrinology & Diabetes, Whittington Health NHS Trust, London, UK., Bitat S; Department of Diabetes & Endocrinology, University College London Hospital NHS Foundation Trust, London, UK., Deyab E; Department of Diabetes & Endocrinology, University College London Hospital NHS Foundation Trust, London, UK., Ponnampalam S; Department of Diabetes & Endocrinology, University College London Hospital NHS Foundation Trust, London, UK., Bouloux PM; Centre for Neuroendocrinology, Royal Free Campus, University College London, London, UK., Montgomery H; Department of Endocrinology & Diabetes, Whittington Health NHS Trust, London, UK.; UCL Institute for Human Health and Performance, University College London, London, UK., Baldeweg SE; Department of Diabetes & Endocrinology, University College London Hospital NHS Foundation Trust, London, UK.; Division of Medicine, University College London, London, UK.
Jazyk:	angličtina
Zdroj:	The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2021 May 13; Vol. 106 (6), pp. 1637-1648.
DOI:	10.1210/clinem/dgab107
Abstrakt:	Context: Dysnatremia is an independent predictor of mortality in patients with bacterial pneumonia. There is paucity of data about the incidence and prognostic impact of abnormal sodium concentration in patients with coronavirus disease 2019 (COVID-19). Objective: This work aimed to examine the association of serum sodium during hospitalization with key clinical outcomes, including mortality, need for advanced respiratory support and acute kidney injury (AKI), and to explore the role of serum sodium as a marker of inflammatory response in COVID-19. Methods: This retrospective longitudinal cohort study, including all adult patients who presented with COVID-19 to 2 hospitals in London over an 8-week period, evaluated the association of dysnatremia (serum sodium < 135 or > 145 mmol/L, hyponatremia, and hypernatremia, respectively) at several time points with inpatient mortality, need for advanced ventilatory support, and AKI. Results: The study included 488 patients (median age, 68 years). At presentation, 24.6% of patients were hyponatremic, mainly due to hypovolemia, and 5.3% hypernatremic. Hypernatremia 2 days after admission and exposure to hypernatremia at any time point during hospitalization were associated with a 2.34-fold (95% CI, 1.08-5.05; P = .0014) and 3.05-fold (95% CI, 1.69-5.49; P < .0001) increased risk of death, respectively, compared to normonatremia. Hyponatremia at admission was linked with a 2.18-fold increase in the likelihood of needing ventilatory support (95% CI, 1.34-3.45, P = .0011). Hyponatremia was not a risk factor for in-hospital mortality, except for the subgroup of patients with hypovolemic hyponatremia. Sodium values were not associated with the risk for AKI and length of hospital stay. Conclusion: Abnormal sodium levels during hospitalization are risk factors for poor prognosis, with hypernatremia and hyponatremia being associated with a greater risk of death and respiratory failure, respectively. Serum sodium values could be used for risk stratification in patients with COVID-19. (© The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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