Background: COVID-19-induced hyponatremia is reportedly associated with pulmonary dysfunction, but mostly among Caucasians. Hence, the current study evaluated sodium status and its correlation with indices of pulmonary dysfunctions among Nigerians of Negroid race. Methods: This was a retrospectively-designed observational study. Data, all obtained at presentation, were acquired from medical records of 480 RT-PCR-confirmed COVID-19 patients managed at a COVID-19-designated treatment facility in Port Harcourt, Southern Nigeria. Analysis of acquired data was done by COVID-19 clinical grades and sodium status using descriptive and inferential statistics. Results: At presentation, hyponatremia and hypernatremia were observed in 47.7% and 1.0% of the entire studied cohorts (n=480), respectively. Both disorders (hyponatremia/hypernatremia) were mostly observed among the moderate, severe, and critical cases. Most hyponatremic cases (n=154;67.2%) and the entire hypernatremic cases (n=5;100%) were of mild grades. Hyponatremics had higher proportions of fever, breathlessness, confusion, and a higher burden of inflammatory markers which increased with worsening hyponatremic grade. Etiologically, hyponatremia was mostly associated with the syndrome of inappropriate anti-diuretic hormone secretion (SIADH) (n=132;56.7%). Among the hyponatremics, an inverse correlation existed between sodium and respiratory rate (RR), while a correlation existed between sodium and oxygen saturation (SpO2). Compared to mild hyponatremics, the moderate/severe hyponatremics had a greater risk of having RR>30 and SpO2 <95%.  Conclusion: Hyponatremia, mostly of mild grade, was common among the studied COVID-19 patients and was associated with indices of pulmonary dysfunctions, including disease severity, inflammatory markers, and SIADH. Hence, hyponatremia should be utilized to triage COVID-19 patients at presentation. However, further studies are recommended to verify these findings.

Background: The relationship between dyslipidemia and the severity of coronavirus disease 2019 (COVID-19) has extensively been characterized in the Western population with a dearth of data among Nigerians. Hence, the current study evaluated the lipid/lipoprotein disorders inherent in COVID-19 and its relationship with disease severity among Nigerians. Methods: This was a retrospective study conducted among 600 patients with RT-PCR-confirmed COVID-19 at the Eleme COVID-19 treatment facility in Port Harcourt, Southern Nigeria. Data were obtained from medical records using validated acquisition templates and analyzed based on lipid/lipoprotein abnormalities and disease severity status. Results: Among those studied, 54.7% had dyslipidemia while others were normolipidemic. HDL-C dyslipidemia was the most common with a preponderance of hypoalphalipoproteinemia (84.4%). Dyslipidemia afflicted mostly middle-aged, males, urban dwellers, the overweight, and those with classic COVID-19-induced respiratory symptoms. Dyslipidemic cohorts had higher pro-calcitonin, C-reactive protein, D-dimer, total white cell count, and neutrophils, but lower albumin, lymphocyte, and platelet counts compared to the normolipidemic cohorts. Dyslipidemic cohorts with concurrent severe COVID-19 had lower levels of TChol, Tg, HDL-C, and LDL-C levels compared to patients with the less-severe disease. HDL-C was the only lipid/lipoprotein parameter that was associated with severe COVID-19 on crude (OR:8.65; CI:5.96-11.44; p<0.001) and adjusted (OR:8.11; CI:5.65-10.87; p<0.001) regression models compared to other lipid/lipoprotein indices. At 96.77% sensitivity and 89.20% specificity, HDL-C had robust predictive potentials (AUC:0.97; CI:0.84-1.00; p<0.001) over COVID-19 severity. Conclusion: Dyslipidemia is frequent among those presenting with COVID-19 in association with disease severity, especially among the HDL-C dyslipidemic cohorts. Hence, these findings should be factored in during COVID-19 treatment among Nigerians with the disease.

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