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The Frequency of Dysnatremia in Patients Admitted with Covid-19 Infection
Kidney International Reports ; 8(3 Supplement):S435-S436, 2023.
Article in English | EMBASE | ID: covidwho-2266119
ABSTRACT

Introduction:

Numerous studies have shown both hyponatremia and hypernatremia to be independently associated with mortality. Patients infected with Covid-19 infection can develop severe life threatening pneumonia and the mortality in these patients can be as high as 20.3% to 27.9%. While respiratory tract involvement is one of the main manifestation of Covid -19 infection, many patients also have associated dysnatremias. The reported prevalence of hyponatremia and hypernatremia in Covid -19 patients has been 25%-45% and 3% to 7% respectively. Recently, it has also been observed that patients with covid-19 infection develop severe treatment resistant hypernatremia > 150 mEq/L, which is difficult to correct. In patients with Covid-19 infection, dysnatremia is a frequent occurrence, although its relationship with mortality needs to be established. We aimed to study the frequency of dysnatremia in patients with Covid -19 infection at different stages of admission. Method(s) This retrospective analysis was conducted at Aga Khan University Hospital, Karachi, Pakistan over a period of twelve weeks. All admitted adult patients with covid -19 were included. Three levels of serum sodium were recorded on admission, maximum level anytime during hospital stay and at the time of discharge or death (+/- 48 hours). Based on the serum level of sodium, three definitions were used hyponatremia, hypernatremia and normonatremia. Hypernatremia was further categorized into mild, moderate and severe. Patients developing acute kidney injury (AKI) was also recorded. The main outcome measure was inpatient mortality. Result(s) The study included 574 patients;median age was 55.6 +/-14.4 years. On admission, the mean sodium was 135.9 +/- 6.4 mEq/L, 39% patients had hyponatremia and 4.7% had hypernatremia. During hospital admission, the percentage of hypernatremia increased to 18.8% 12.7% had mild, 4.5% had moderate and 1.6% had severe hypernatremia. The mean serum sodium, during hospital stay, in patients who survived was around 140.6 +/- 5 as compared to 151 +/- 9.9 mEq/L in those who died with p value <0.001. The last mean serum sodium checked before death or discharge (+/- 48 hours) was 145.4 +/- 9.4 mEq/L as opposed to 137.7 +/- 3.7 mEq/L with p value of <0.001 in patients who died and survived respectively. The mean serum creatinine on admission was 1.3 +/-1.3 mg/dl;200 (34.8%) patients developed AKI;100 (50%) patients developed stage 1 AKI, 49 (24.5%) had stage 2 and 50 (25%) had stage 3 AKI. Around 36 (6.3%) required renal replacement therapy. The predictors of AKI included severity of Covid-19 [p = 0.001], age [p = <0.001], hypertension [p = 0.04] and invasive ventilation [p = 0.01]. Overall, mortality was 10.97%. Conclusion(s) Hyponatremia on admission is commonly seen in patients admitted with Covid -19 infection, whereas hypernatremia is a frequent finding in patients who could not survive, however their association with mortality needs to be established. No conflict of interestCopyright © 2023
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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Kidney International Reports Year: 2023 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Kidney International Reports Year: 2023 Document Type: Article