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Serum sodium alterations in SARS CoV-2 (COVID-19) infection: impact on patient outcome.
Berni, Andrea; Malandrino, Danilo; Corona, Giovanni; Maggi, Mario; Parenti, Gabriele; Fibbi, Benedetta; Poggesi, Loredana; Bartoloni, Alessandro; Lavorini, Federico; Fanelli, Andrea; Scocchera, Giulia; Nozzoli, Carlo; Peris, Adriano; Pieralli, Filippo; Pini, Riccardo; Ungar, Andrea; Peri, Alessandro.
  • Berni A; Internal Medicine Unit 3, Careggi University Hospital, Florence, Italy.
  • Malandrino D; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
  • Corona G; Endocrinology Unit, Medical Department, Azienda Usl Bologna Maggiore-Bellaria Hospital, Bologna, Italy.
  • Maggi M; Endocrinology Unit, Careggi University Hospital, Florence, Italy.
  • Parenti G; Department of Experimental and Clinical Biomedical Sciences 'Mario Serio', University of Florence, Florence, Italy.
  • Fibbi B; Endocrinology Unit, Careggi University Hospital, Florence, Italy.
  • Poggesi L; Pituitary Diseases and Sodium Alterations Unit, Careggi University Hospital, Florence, Italy.
  • Bartoloni A; Endocrinology Unit, Careggi University Hospital, Florence, Italy.
  • Lavorini F; Pituitary Diseases and Sodium Alterations Unit, Careggi University Hospital, Florence, Italy.
  • Fanelli A; Internal Medicine Unit 3, Careggi University Hospital, Florence, Italy.
  • Scocchera G; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
  • Nozzoli C; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
  • Peris A; Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy.
  • Pieralli F; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
  • Pini R; Pneumology and Thoraco Pulmonary Pathophysiology Unit, Careggi University Hospital, Florence, Italy.
  • Ungar A; Internal Medicine Unit 2, Careggi University Hospital, Florence, Italy.
  • Peri A; Internal Medicine Unit 2, Careggi University Hospital, Florence, Italy.
Eur J Endocrinol ; 185(1): 137-144, 2021 May 28.
Article in English | MEDLINE | ID: covidwho-1477604
Semantic information from SemMedBD (by NLM)
1. Pneumonia PROCESS_OF Patients
Subject
Pneumonia
Predicate
PROCESS_OF
Object
Patients
2. Electrolyte imbalance PROCESS_OF hospitalized patients
Subject
Electrolyte imbalance
Predicate
PROCESS_OF
Object
hospitalized patients
3. COVID-19 PROCESS_OF hospitalized patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
hospitalized patients
4. Hyponatremia COEXISTS_WITH multiple pathologies
Subject
Hyponatremia
Predicate
COEXISTS_WITH
Object
multiple pathologies
5. Serum LOCATION_OF sodium
Subject
Serum
Predicate
LOCATION_OF
Object
sodium
6. Hypernatremia PROCESS_OF Patients
Subject
Hypernatremia
Predicate
PROCESS_OF
Object
Patients
7. Hyponatremia PROCESS_OF Patients
Subject
Hyponatremia
Predicate
PROCESS_OF
Object
Patients
8. Increased risk COEXISTS_WITH Hyponatremia
Subject
Increased risk
Predicate
COEXISTS_WITH
Object
Hyponatremia
9. hospitalized patients LOCATION_OF sodium
Subject
hospitalized patients
Predicate
LOCATION_OF
Object
sodium
10. Pneumonia PROCESS_OF Patients
Subject
Pneumonia
Predicate
PROCESS_OF
Object
Patients
11. Electrolyte imbalance PROCESS_OF hospitalized patients
Subject
Electrolyte imbalance
Predicate
PROCESS_OF
Object
hospitalized patients
12. COVID-19 PROCESS_OF hospitalized patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
hospitalized patients
13. Hyponatremia COEXISTS_WITH multiple pathologies
Subject
Hyponatremia
Predicate
COEXISTS_WITH
Object
multiple pathologies
14. Serum LOCATION_OF sodium
Subject
Serum
Predicate
LOCATION_OF
Object
sodium
15. Hypernatremia PROCESS_OF Patients
Subject
Hypernatremia
Predicate
PROCESS_OF
Object
Patients
16. Hyponatremia PROCESS_OF Patients
Subject
Hyponatremia
Predicate
PROCESS_OF
Object
Patients
17. Increased risk COEXISTS_WITH Hyponatremia
Subject
Increased risk
Predicate
COEXISTS_WITH
Object
Hyponatremia
18. hospitalized patients LOCATION_OF sodium
Subject
hospitalized patients
Predicate
LOCATION_OF
Object
sodium
ABSTRACT

OBJECTIVE:

Hyponatremia is the most common electrolyte disorder in hospitalized patients and occurs in about 30% of patients with pneumonia. Hyponatremia has been associated with a worse outcome in several pathologic conditions The main objective of this study was to determine whether serum sodium alterations may be independent predictors of the outcome of hospitalized COVID-19 patients. DESIGN AND

METHODS:

In this observational study, data from 441 laboratory-confirmed COVID-19 patients admitted to a University Hospital were collected. After excluding 61 patients (no serum sodium at admission available, saline solution infusion before sodium assessment, transfer from another hospital), data from 380 patients were analyzed.

RESULTS:

274 (72.1%) patients had normonatremia at admission, 87 (22.9%) patients had hyponatremia and 19 (5%) patients had hypernatremia. We found an inverse correlation between serum sodium and IL-6, whereas a direct correlation between serum sodium and PaO2/FiO2 ratio was observed. Patients with hyponatremia had a higher prevalence of non-invasive ventilation and ICU transfer than those with normonatremia or hypernatremia. Hyponatremia was an independent predictor of in-hospital mortality (2.7-fold increase vs normonatremia) and each mEq/L of serum sodium reduction was associated with a 14.4% increased risk of death.

CONCLUSIONS:

These results suggest that serum sodium at admission may be considered as an early prognostic marker of disease severity in hospitalized COVID-19 patients.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Sodium / Severity of Illness Index / SARS-CoV-2 / COVID-19 Type of study: Observational study / Prognostic study / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Eur J Endocrinol Journal subject: Endocrinology Year: 2021 Document Type: Article Affiliation country: Eje-20-1447

Full text: Available Collection: International databases Database: MEDLINE Main subject: Sodium / Severity of Illness Index / SARS-CoV-2 / COVID-19 Type of study: Observational study / Prognostic study / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Eur J Endocrinol Journal subject: Endocrinology Year: 2021 Document Type: Article Affiliation country: Eje-20-1447