Prevalence and outcome of dysnatremia in patients with COVID-19 compared to controls - Atila, C.; Sailer, C. O.; Bassetti, S.; Tschudin-Sutter, S.; Bingisser, R.; Siegemund, M.; Osswald, S.; Rentsch, K.; Rueegg, M.; Schaerli, S.; Kuster, G. M.; Twerenbold, R.; et al. (Eur J Endocrinol, 2021)
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.
Keywords: journalArticle; Adult; Aged; COVID-19/complications/*diagnosis/*epidemiology/therapy; Case-Control Studies; Cohort Studies; Critical Care/statistics & numerical data; Female; Hospital Mortality; Hospitalization/statistics & numerical data; Humans; Hypernatremia/complications/*diagnosis/*epidemiology/therapy; Hyponatremia/complications/*diagnosis/*epidemiology/therapy; Length of Stay/statistics & numerical data; Male; Middle Aged; Mortality; Pandemics; Prevalence; Prognosis; Prospective Studies; SARS-CoV-2; Switzerland/epidemiology; Triage