Serum Sodium, Patient Symptoms, and Clinical Outcomes in Hospitalized Patients with COVID-19

Yen, Timothy; Kim, Andy; Benson, Maura; Ratnaparkhi, Saee; Causland, Finnian R. Mc

doi:10.1177/21501319211067349

Cited by 3 publications

(11 citation statements)

References 24 publications

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“…The heterogeneity between the studies decreased by 10.2% with the exception of the Atila study, 19 suggesting that this study may be one of the main sources of heterogeneity. Furthermore, we found an equally significant decline in the heterogeneity (down 4.7%) after excluding the yen study 24 …”

Section: Resultsmentioning

confidence: 56%

“…We then analyzed subgroups from seven retrospective cohort studies, see Figure 5B, and again, there was a significant association (OR = 4.47, 95% CI 3.91–5.12, p < 0.05). We did not perform subgroup analyses prospective studies alone, as these two original papers were the main source of heterogeneity 19,24 …”

Section: Resultsmentioning

confidence: 99%

“…Initially, 253 publications were researched, including 24 in PubMed, 48 in Web of Science, 168 in Embase, and 13 in Cochrane, with articles published up to August 27, 2022. Seventy‐eight duplicates were removed using Endnote software, then the titles and abstracts of the literature were read according to the inclusion and exclusion criteria, 142 irrelevant papers were excluded, and finally, the contents of the remaining 33 papers were carefully read, and a total of 9 matching papers were included 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 (Figure 1 ). The nine included studies, seven of which were retrospective cohort studies 17 , 18 , 20 , 21 , 22 , 23 , 25 and two prospective cohort studies, 19 , 24 included a total of 11,801 patients suffering from COVID‐19, including 10,523 patients with normal blood sodium and 1278 patients with hypernatremia, with an incidence of 10.8% hypernatremia and a mortality rate of 48.7%.…”

Section: Resultsmentioning

confidence: 99%

“…We did not perform subgroup analyses prospective studies alone, as these two original papers were the main source of heterogeneity. 19,24 We also analyzed the relationship between hypernatremia and admission to the ICU. A total of five original papers 19,20,[23][24][25] documented ICU admissions in patients with COVID-19, and due to the large heterogeneity of the analysis using a fixed-effects model (I² = 85.7%), a randomeffects model analysis was used, which showed an association between hypernatremia and ICU admission (OR = 3.51, 95% CI 1.12-11.01, I² = 85.6%), (Figure 6).…”

Section: Subgroup Analysismentioning

confidence: 99%

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Association of hypernatremia with mortality in patients with COVID‐19: A systematic review and meta‐analysis

Ma,

Zhang,

Hou

2023

Immunity Inflam & Disease

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BackgroundThe COVID‐19 pandemic worldwide has caused varying degrees of severity of lung damage in patients, with acute respiratory distress and death in severe cases. However, this is not directly caused by the virus itself, but by the production of inflammasome by monocytes in the body, leading to a systemic inflammatory response, which results in a very poor clinical prognosis for patients with COVID‐19.ObjectiveThe purpose of this meta‐analysis was to look at the relationship between hypernatremia and mortality in COVID‐19 patients.MethodsWe searched the PubMed, Web of Science, Embase, and Cochrane databases for articles published from the inception of the database until August 27, 2022. Three researchers reviewed the literature, retrieved data, and assessed the quality of the literature, respectively. A meta‐analysis was performed using State 17 software to assess the value of the effect of hypernatremia on mortality in patients with new coronavirus pneumonia.ResultsA total of nine publications was finally included in this study, including a total of 11,801 patients with COVID‐19, including 1278 in the hypernatremia group and 10,523 in the normonatremia group. Meta‐analysis showed that hypernatremia was associated with mortality in patients with COVID‐19 [OR = 4.15, 95% CI (2.95–5.84), p = .002, I² = 66.7%] with a sensitivity of 0.36 [0.26, 0.48] and a specificity of 0.88 [0.83, 0.91]. The posterior probability of mortality was 42% in patients with COVID‐19 hypernatremia and 15% in patients who did not have COVID‐19 hypernatremia.ConclusionAccording to available data, hypernatremia is associated with death in patients with COVID‐19.

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Section: Resultsmentioning

confidence: 56%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Subgroup Analysismentioning

confidence: 99%

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Association of hypernatremia with mortality in patients with COVID‐19: A systematic review and meta‐analysis

Ma,

Zhang,

Hou

2023

Immunity Inflam & Disease

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“…19 In the study of Yen et al hypernatremia was independently associated with higher odds of confusion and in-hospital mortality. 20 Despite the common occurrence of hyponatremia in patients with CAP, the underlying mechanisms remain disputed SIADH has been identified as a common aetiology and may be induced by stimuli, including pain, nausea, hypovolemia, and certain medications. 21 Other factors contributing to SIADH in pneumonia are hypoxic pulmonary vasoconstriction with subsequent reduced left atrial filling, leading to increased ADH secretion.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and outcome of hyponatremia in patients admitted with COVID-19

2022

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Background: Hyponatremia occurs in up to 30% of patients with pneumonia and is associated with increased morbidity and mortality. The prevalence of hyponatremia associated with coronavirus disease 2019 and the impact on outcome is unknown. We aimed to identify the prevalence, and outcome of patients having hyponatremia admitted with COVID-19. Methods: This was a retrospective observational study conducted among admitted adult patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Srinivas institute of medical sciences and research centre, Mukka, Surathkal.Results: This difference in hyponatremia was statistically significant with regard to age (p<0.001), respiratory rate (p=0.002), SpO2 (p=0.029), total counts (p=0.03), CRP (p=0.005), and d-dimer (p=0.015).Conclusions: In patients with COVID-19, age, hypotension, respiratory rate, SpO2, total counts, CRP, and D-Dimer have significant correlation with hyponatremia. Also, patients with COVID-19 and hyponatremia have higher rates of mechanical ventilation and mortality.

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The effect of dysnatremia on prognosis and mortality in critically ill patients with COVID-19

bayrakçı

2023

Int J Med Biochem

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The effect of dysnatremia on prognosis and mortality in critically ill patients with COVID-19 S odium disorders are the most common electrolyte disorders in hospitalized patients. Dysnatremias: hyponatremia and hypernatremia (defined as the levels of serum sodium <135 mmol/L and above 145 mmol/L, respectively) are common in hospitalized patients with pneumonia. It has been shown in numerous studies that sodium abnormalities are independent risk factors for mortality, admission to medical intensive care units (ICU), and prolonged length of hospital stay [1]. The prevalence of hyponatremia in hospitalized patients is 30%. Many studies have demonstrated that in patients with bacterial pneumonia, hyponatremia is the most prevalent electrolyte abnormality. The syndrome of inappropriate antidiuretic hormone secretion and hypovolemia is the most common causes of hyponatremia [2-4]. Due to infection, proinflammatory cytokines (like interleukin-1β and interleukin-6) are secreted excessively, and as a result, non-osmotic release of arginine vasopressin, which causes hyponatremia due to SIAD, is induced [5, 6]. Therefore, hyponatremia is a good Objectives: Sodium disorders, the most common electrolyte disorders in hospitalized patients, are common in hospitalized patients with pneumonia. Numerous studies have shown that sodium abnormalities are independent risk factors for mortality, medical intensive care unit (ICU) admission, and prolonged hospital stay. The aim of the study was to investigate the prevalence of dysnatremia and the effect of dysnatremia on prognosis and mortality in critically ill COVID-19 patients. Methods: This retrospective study was performed between June 1, 2021, and July 30, 2021, in COVID-19 ICUs. 149 critically ill, laboratory-confirmed COVID-19 patients admitted to the ICU were included in the study. The collected data included demographic data, comorbidities, severity of illness, and laboratory tests (serum C-reactive protein, lymphocyte, ferritin, sodium, chloride, and potassium levels). The prognosis was evaluated in terms of mortality, need for mechanical ventilation, and length of ICU stay.Results: At ICU admission, hyponatremia was present in 33 (22.1%) patients, whereas hypernatremia was detected in 14 (9.5%) patients. 102 (68.4%) patients had normal sodium levels. The mortality rate for normonatremic, hyponatremic, and hypernatremic patients was 50.0%, 57.7%, and 78.6%, respectively. These results indicated a statistically significantly higher mortality rate in patients with baseline hypernatremia (p=0.05). Conclusion:Among critically ill COVID-19 patients in the ICU, dysnatremia was common at admission and hyponatremia was more common than hypernatremia. Hypernatremia was related to mortality. Admission sodium levels can be a predictor of mortality in COVID-19 patients who are critically ill.

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Serum Sodium, Patient Symptoms, and Clinical Outcomes in Hospitalized Patients with COVID-19

Cited by 3 publications

References 24 publications

Association of hypernatremia with mortality in patients with COVID‐19: A systematic review and meta‐analysis

Association of hypernatremia with mortality in patients with COVID‐19: A systematic review and meta‐analysis

Prevalence and outcome of hyponatremia in patients admitted with COVID-19

The effect of dysnatremia on prognosis and mortality in critically ill patients with COVID-19

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