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Dysnatremia Tied to Poorer Prognosis in Hospitalized COVID-19 Patients

Hypernatremia linked to increased mortality, while hyponatremia at admission linked to increased odds of needing ventilatory support

WEDNESDAY, March 3, 2021 (HealthDay News) — For patients presenting with COVID-19, abnormal sodium levels are associated with mortality and needing ventilatory support, according to a study published online Feb. 24 in the Journal of Clinical Endocrinology & Metabolism.

Ploutarchos Tzoulis, M.D., Ph.D., from University College London, and colleagues conducted a retrospective longitudinal cohort study involving all 488 adults presenting with COVID-19 to two hospitals in London during an eight-week period. The association of dysnatremia (hyponatremia [serum sodium, <135 mmol/L] and hypernatremia [serum sodium, >145 mmol/L]) with inpatient mortality, need for advanced ventilator support, and acute kidney injury (AKI) was examined.

The researchers found that 24.6 and 5.3 percent of patients were hyponatremic (mainly due to hypovolemia) and hypernatremic, respectively, at presentation. Compared with normonatremia, hypernatremia two days after admission and exposure to hypernatremia at any time point during hospitalization was associated with 2.34-fold and 3.05-fold increased risk for death, respectively. The likelihood of needing ventilatory support was increased 2.18-fold with hyponatremia at admission. Hyponatremia was not associated with the risk for in-hospital mortality, except for in the subgroup with hypovolemic hyponatremia. There was no association seen between sodium values and the risk for AKI or length of hospital stay.

“Sodium measurements can inform doctors about which COVID-19 patients are at high risk of deterioration and death,” Tzoulis said in a statement. “Sodium levels can guide decision making about whether a COVID-19 patient needs hospital admission or monitoring in the intensive care unit.”

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