Adding Hyponatremia to the 'Rule-of-6' Prediction Tool Improves Performance in Identifying Hospitalised Patients with COVID-19 at Risk of Adverse Clinical Outcomes

Autor: Meng Ying Sim, Jinghao Nicholas Ngiam, Matthew Chung Yi Koh, Wilson Goh, Srishti Chhabra, Nicholas W. S. Chew, Louis Yi Ann Chai, Paul Anantharajah Tambyah, Ching-Hui Sia
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Pathogens, Vol 13, Iss 8, p 694 (2024)
Druh dokumentu: article
ISSN: 2076-0817
DOI: 10.3390/pathogens13080694
Popis: The ‘rule-of-6’ prediction tool was shown to be able to identify COVID-19 patients at risk of adverse outcomes. During the pandemic, we frequently observed hyponatremia at presentation. We sought to evaluate if adding hyponatremia at presentation could improve the ‘rule-of-6’ prediction tool. We retrospectively analysed 1781 consecutive patients admitted to a single tertiary academic institution in Singapore with COVID-19 infection from February 2020 to October 2021. A total of 161 (9.0%) patients had hyponatremia. These patients were significantly older, with more co-morbidities and more likely to be admitted during the Delta wave (2021). They were more likely to have radiographic evidence of pneumonia (46.0% versus 13.0%, p < 0.001) and more adverse outcomes (25.5% vs. 4.1%, p < 0.001). Hyponatremia remained independently associated with adverse outcomes after adjusting for age, lack of medical co-morbidities, vaccination status, year of admission, CRP, LDH, and ferritin. The optimised cut-off for serum sodium in predicting adverse outcomes was approximately
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