Serum sodium alterations in SARS CoV-2 (COVID-19) infection: impact on patient outcome
Serum sodium alterations in SARS CoV-2 (COVID-19) infection: impact on patient outcome
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DOI：
10.1530/eje-20-1447
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发表时间：
2021-07-01
影响因子：
5.8
通讯作者：
Peri, Alessandro
中科院分区：
文献类型：
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作者：
Berni, Andrea;Malandrino, Danilo;Peri, Alessandro
目的：低钠血症是住院患者中最常见的电解质紊乱，约30%的肺炎患者发生低钠血症。低钠血症与几种病理条件下的不良结局相关本研究的主要目的是确定血清钠变化是否可能是住院COVID-19患者结局的独立预测因素设计和方法：在这项观察性研究中，收集了441例实验室确诊的COVID-19患者的数据。排除61例患者（入院时无血钠，钠评估前输注生理盐水，从另一家医院转移）后，分析了380例患者的数据。结果：274例（72.1%）患者入院时有正常钠血症，87例（22.9%）患者有低钠血症，19例（5%）患者有高钠血症。我们发现血清钠与IL-6之间呈负相关，而血清钠与符号率之间呈直接相关。低钠血症患者无创通气和ICU转移的发生率高于正常钠血症或高钠血症患者。低钠血症是院内死亡率的独立预测因子（与正常钠血症相比增加2.7倍），血清钠每减少mEq/L，死亡风险增加14.4%。结论：这些结果表明，入院时的血清钠可被视为住院COVID-19患者疾病严重程度的早期预后标志物。
Objective: Hyponatremia is the most common electrolyte disorder in hospitalized patients and occurs in about 30% of patients with pneumonia. Hyponatremia has been associated with a worse outcome in several pathologic conditions The main objective of this study was to determine whether serum sodium alterations may be independent predictors of the outcome of hospitalized COVID-19 patients.Design and methods: In this observational study, data from 441 laboratory-confirmed COVID-19 patients admitted to a University Hospital were collected. After excluding 61 patients (no serum sodium at admission available, saline solution infusion before sodium assessment, transfer from another hospital), data from 380 patients were analyzed.Results: 274 (72.1%) patients had normonatremia at admission, 87 (22.9%) patients had hyponatremia and 19 (5%) patients had hypernatremia. We found an inverse correlation between serum sodium and IL-6, whereas a direct correlation between serum sodium and symbolscript ratio was observed. Patients with hyponatremia had a higher prevalence of non-invasive ventilation and ICU transfer than those with normonatremia or hypernatremia. Hyponatremia was an independent predictor of in-hospital mortality (2.7-fold increase vs normonatremia) and each mEq/L of serum sodium reduction was associated with a 14.4% increased risk of death.Conclusions: These results suggest that serum sodium at admission may be considered as an early prognostic marker of disease severity in hospitalized COVID-19 patients.