Prevalence and outcome of dysnatremia in patients with COVID-19 compared to controls
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Prevalence and outcome of dysnatremia in patients with COVID-19 compared to controls. / 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.
In: EUR J ENDOCRINOL, Vol. 184, No. 3, 03.2021, p. 409-418.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Prevalence and outcome of dysnatremia in patients with COVID-19 compared to controls
AU - Atila, Cihan
AU - Sailer, Clara O
AU - Bassetti, Stefano
AU - Tschudin-Sutter, Sarah
AU - Bingisser, Roland
AU - Siegemund, Martin
AU - Osswald, Stefan
AU - Rentsch, Katharina
AU - Rueegg, Marco
AU - Schaerli, Sabrina
AU - Kuster, Gabriela M
AU - Twerenbold, Raphael
AU - Christ-Crain, Mirjam
PY - 2021/3
Y1 - 2021/3
N2 - 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.
AB - 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.
KW - Adult
KW - Aged
KW - COVID-19/complications
KW - Case-Control Studies
KW - Cohort Studies
KW - Critical Care/statistics & numerical data
KW - Female
KW - Hospital Mortality
KW - Hospitalization/statistics & numerical data
KW - Humans
KW - Hypernatremia/complications
KW - Hyponatremia/complications
KW - Length of Stay/statistics & numerical data
KW - Male
KW - Middle Aged
KW - Mortality
KW - Pandemics
KW - Prevalence
KW - Prognosis
KW - Prospective Studies
KW - SARS-CoV-2
KW - Switzerland/epidemiology
KW - Triage
U2 - 10.1530/EJE-20-1374
DO - 10.1530/EJE-20-1374
M3 - SCORING: Journal article
C2 - 33449918
VL - 184
SP - 409
EP - 418
JO - EUR J ENDOCRINOL
JF - EUR J ENDOCRINOL
SN - 0804-4643
IS - 3
ER -
