RISK FACTORS AND CLINICAL OUTCOMES OF HYPONATREMIA IN COVID-19 PATIENTS ADMITTED AT A TERTIARY HOSPITAL FROM JANUARY 1, 2021 TO DECEMBER 31, 2021: A CASE-CONTROL STUDY
Miss Jill Therese Au1, Dr Brian Michael Cabral1
1slmc-gc, taguig, philippines
Aim: This study was conducted to identify the risk factors associated with hyponatremia (Na < 135mmol/L) in COVID-19 patients. The clinical outcomes of COVID-19 patients with and without hyponatremia were compared.
Background: Systemic inflammation has been associated with severe COVID-19 disease and mortality. Studies have found that hyponatremia in COVID-19 can result from inflammation-induced non-osmotic release of antidiuretic hormone.
Methods: This case-control study included a total of 384 COVID-19 patients aged 18 years old and above who were admitted at a tertiary hospital in the Philippines from January 1, 2021 to December 31, 2021. Chart review was done for data collection. The clinical outcomes analyzed include in-hospital mortality, need for ICU admission, need for ventilator support, acute kidney injury, and length of hospital stay.
Results: Patients with hyponatremia were found to be significantly older with male predominance. The presence of acute kidney injury had a significant association with hyponatremia. As compared to the normonatremic group, patients with hyponatremia had higher white blood cell count, neutrophil-to-lymphocyte ratio, absolute neutrophil count and inflammatory markers (ferritin, CRP, IL-6, procalcitonin) but lower absolute lymphocyte count. Hyponatremia in COVID-19 patients had also been found to carry approximately two to three times the risk for adverse outcomes such as prolonged hospitalization, acute kidney injury, in-hospital mortality, need for ICU admission and need for intubation. Binary logistic regression showed that the significant predictors of hyponatremia include age, presence of acute kidney injury, absolute lymphocyte count, and ferritin level.
Conclusion: Hyponatremia in COVID-19 patients is significantly associated with adverse clinical outcomes. Determination of serum sodium may be used in the local setting to identify COVID-19 patients at high risk for poor clinical outcomes.
Biography:
Dr Brian Michael Cabral is a transplant nephrologist who is currently practicing in the Philippines. He accomplished Internal Medicine training in Ohio and had his fellowship training in General Nephrology and Transplant Nephrology in Chicago, Illinois. He is one of the many healthcare professionals who battled COVID-19 during the pandemic.