[Dysnatremias and their association with morbidity and mortality in patients with COVID- 19]

Background: Coronavirus disease 2019 (COVID-19) has provoked one of the greatest health crises of our time, which is why risk stratification at the time of hospitalization is essential to identify in good time patients with high morbidity and mortality risk. Dysnatremia as an independent predictor of mortality in patients with COVID-19 has recently become relevant. Objective: To find out if there is an association of dysnatremia with 28-day mortality, and as secondary objectives, its association with hospital stay, invasive mechanical ventilation (IMV) requirement and presence of acute kidney injury (AKI) during hospital stay. Material and methods: Retrospective, descriptive and analytical cohort study. All consecutive patients of 16 years or older of any gender, admitted to a third level hospital from March 1, 2020 to March 2021, who have a diagnosis of COVID-19 with positive PCR were included. Results: The study included a total of 722 patients. The prevalence of dysnatremia was as follows: 18 patients presented hypernatremia (2.49%) and 153 hyponatremia (21.19%). The presence of hypernatremia once sodium was corrected for glucose was associated with higher mortality (p < 0.05, OR 3.446;95% CI 1.776-6.688), an increased probability of presenting AKI (p <0.05, OR 2.985;95% CI 1.718-5.184) and a greater requirement for IMV (p < 0.05, OR 1.945;95% CI 1.701-5.098). Conclusions: Hypernatremia was associated with higher mortality, higher risk of presenting AKI and the requirement for IMV during hospitalization.

[Sodium-chlorine difference as a prognostic predictor in adult patients diagnosed with COVID-19]

Background: Hyperchloremia has been associated with a greater presence of morbidity and mortality, mainly described in critically ill patients, this may be relative and absolute, which could be reflected in the sodium-chloride difference. Objective: The primary objective was to determine whether the sodium-chloride difference <31 mEq/L measured 24-48 hours after admission is a predictor of 28-day mortality in patients with COVID-19, and as secondary objectives to identify whether it is associated with higher requirement for invasive mechanical ventilation, presence of acute kidney injury and longer hospital stay. Material and methods: Retrospective, descriptive and analytical longitudinal cohort study, was done including all consecutive patients older than 16 years of any gender, admitted to the UMAE from March 1, 2020 to March 2021, which present a diagnosis of COVID-19 with RT-PCR test for SARS-CoV-2 positive. Results: A total of 722 patients were included, the difference sodium-chloride < 31 mEq/L is not associated with an increased risk of death at 28 days (p = 1.172, OR: 1.35;95%CI, 0.87-2.08) or requirement of mechanical ventilation (p = 0.47, OR: 1.19;95%CI, 0.76-1.86), but is associated with a higher risk of AKI (p < 0.05, OR: 2.04;95%CI, 1.33- 3.14) and longer hospital stay (p < 0.05). Conclusions: the sodium-chloride difference < 31 mEq/L in the first hours of admission is associated with a higher risk of presenting acute kidney injury during hospital stay in patients with COVID-19, as well as a longer hospital stay.