ABSTRACT
Introduction: Dysnatremia is common in patients with acute coronavirus disease 2019 (COVID-19). Robust studies looking at the association between sodium imbalance in patients with COVID-19 and clinical outcome remain lacking.This study aimed to identify the prevalence of dysnatremia among patients hospitalized with acute COVID-19 infection. It also sought to determine the association between serum sodium and both mortality and morbidity, as measured by the severity of COVID-19 infection, the need for ventilatory support, intensive care unit (ICU) admission and acute kidney injury (AKI). We sought to evaluate whether sodium levels, a relatively inexpensive and easily accessible lab investigation, may be employed as a predictor of outcome in patients admitted with COVID-19 infection. Method(s): This was a retrospective cohort studyconducted from an electronic medical records review of all hospitalized, adult patients with laboratory-confirmed coronavirus disease 2019 (COVID-19) at the University Hospital of the West Indies between August 1, 2020, and January 31, 2021. The relationship between dysnatremia (serum sodium <135 mmol/l or >145 mmol/l) and in-hospital mortality and morbidity were examined. A total of 374 COVID-19 patients were enrolled. The study was approved by the Mona Campus Research Ethics Committee, an independent body which is housed in the Faculty of Medical Sciences, University of the West Indies, Mona, Jamaica. Result(s): The incidence of hyponatremia and hypernatremia were 29.4% and 6.1% respectively. The mean admission serum sodium was 137.3 +/- 6.0 mmol/l. At the end of the study period, the prevalence of hyponatremia and hypernatremia was 50.3% and 19.8% respectively. Acute kidney injury occurred in 117 patients (31.3%) with 23 patients (6.1%) having an unknown status due to missing data. Hypernatremia was associated with a higher prevalence of AKI (60.9%) than hyponatremia (35.5%) (chi2=13.8, p=0.008). Serum sodium at presentation was higher among the non-survivors (139.3 +/- 7.2 mmol/l), compared to the survivors (136.7 +/- 5.5 mmol/l) (p<0.001). Patients with hypernatremia had a survival rate of 52.2% at a survival average of 18.3 days, significantly lower than patients with hyponatremia (80.9%) or normonatremia (77.6%) (p=0.001). There was statistically significant association between the presence of hypernatremia and in-patient mortality (chi2=9.0, p=0.011) but there was no association with hyponatremia. The majority of the patients (56.1%) had severe COVID-19 infection. Non-severe and critically ill patients accounted for 32.1% and 11.8% respectively.Comparison of serum sodium at presentation to the severity of COVID-19 infection did not show statistical significance(chi2=1.7, p=0.794). There was no statistically significant difference between serum sodium levels and oxygen therapy (chi2=1.4, p=0.502) or the use of mechanical ventilatory support (chi2=4.6, p=0.798). There was no statistical significance in the length of hospital stay across sodium groups (p=0.179). Conclusion(s): Hypernatremia was associated with both a higher risk of acute kidney injury and in-hospital mortality, but not morbidity. Hyponatremia either on admission or developed during the hospitalization was not associated with poor clinical outcomes. Serum sodium can be used in the prognostication and risk stratification of patients with acute COVID-19 infection. No conflict of interestCopyright © 2023
ABSTRACT
The outbreak of COVID-19 has led to the increase in face mask waste globally. In this study, face mask-derived carbocatalysts doped with nitrogen (N-Mask) were fabricated through one-step pyrolysis of 1:5 w/w mixture of face mask and urea at different temperatures to activate peroxymonosulfate (PMS) for gatifloxacin (GAT) degradation. The N-Mask prepared at 800 degrees C (N-Mask800) exhibited the highest GAT degradation rate with k(app) = 0.093 min(-1) which could be attributed to its high N doping level (17.1 wt%) and highest specific surface area (237.13 m(2) g(-1)). The relationship between k(app), catalyst loading and PMS dosage at various pHs on GAT degradation were successfully established. It was also found that the GAT degradation rate was inhibited in the sequential operating mode compared to the simultaneous operating mode. It was construed that adsorption and catalysis share the same active sites. Deterioration in catalytic performance was observed over successive cycles due to the surface chemistry change during catalysis, and difficulty in catalyst recovery after treatment. Radical scavenger study revealed that both radical and nonradical pathways were involved during GAT degradation, with nonradical pathway playing a dominant role. XPS analysis revealed that pyrrolic N and graphitic N can facilitate PMS activation via radical and nonradical pathways. Based on the LC-MS/MS analysis, the GAT degradation intermediates were identified, and the possible degradation pathways were tentatively proposed. Overall, this study demonstrated that carbocatalyst derived from face mask could be transformed into costeffective and environmentally friendly PMS activator for environmental wastewater treatment applications.