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- Title
Prevalence and outcome of dysnatremia in patients with COVID-19 compared to controls.
- Authors
Atila, Cihan; Sailer, Clara O.; Bassetti, Stefano; Tschudin-Sutter, Sarah; Bingisser, Roland; Siegemund, Martin; Osswald, Stefan; Rentsch, Katharina; Rueegg, Marco; Schaerli, Sabrina; Kuster, Gabriela M.; Twerenbold, Raphael; Christ-Crain, Mirjam
- 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.
- Subjects
HYPONATREMIA; COVID-19; HYPERNATREMIA; COVID-19 pandemic; PROPORTIONAL hazards models; INTENSIVE care units; SARS-CoV-2
- Publication
European Journal of Endocrinology, 2021, Vol 184, Issue 3, p413
- ISSN
0804-4643
- Publication type
Article
- DOI
10.1530/EJE-20-1374