Relationship between hyponatremia at hospital admission and cardiopulmonary profile at follow-up in patients with SARS-CoV-2 (COVID-19) infection

Malandrino, Danilo; Berni, Andrea; Fibbi, Benedetta; Borellini, B.; Cozzi, Diletta; Norello, Dario; Fattirolli, Francesco; Lavorini, Federico; Olivotto, Iacopo; Fumagalli, Carlo; Zocchi, Chiara; Tassetti, Luigi; Gozzi, Licia; Marchionni, Niccolò; Maggi, Mario; Peri, Alessandro; Spinicci, Michele; Zammarchi, Lorenzo; Gori, Leonardo; Bernacchi, Guja; Ciambellotti, Lorenzo; Vellere, Iacopo; Vannini, Matteo; Montali, Sara; Tonarelli, Francesco; Camartini, Viola; Turrin, Giada; Testa, Giuseppe Dario; Virciglio, S; Gardellini, Enrico; Corsi, Carolina; Tofalos, Sofia Espinoza; Marcucci, Rossella; Rasero, Laura; Giovannoni, Lorenzo; Livi, Luca; Silverii, Maria Vittoria

doi:10.1007/s40618-022-01938-9

Cited by 3 publications

(1 citation statement)

References 47 publications

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“…It occurs in approximately 20-64% of patients with COVID-19. [34][35][36][37][38][39] Previous studies have indicated increased odds of poor outcomes among COVID-19 patients with hyponatremia, and most of them regarded hyponatremia as a bystander factor rather than a risk factor. 38 However, our study found that baseline hyponatremia before infection was associated with worse outcomes, suggesting that hyponatremia may also be a contributor to poor outcomes, at least in the PD population.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 and outcomes in Chinese peritoneal dialysis patients

Liao,

Zhou,

et al. 2024

Perit Dial Int

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Background: Reports on COVID-19 in peritoneal dialysis (PD) patients are scarce in China. This study aimed to describe the characteristics and outcomes of PD patients with COVID-19 after China abandoned the ‘zero-COVID’ policy. Methods: This single-centre retrospective study included patients receiving PD who underwent testing for COVID-19 infections between 7 December 2022 and 7 January 2023. Outcomes of interest included factors associated with positive COVID-19 testing result and clinical outcomes including COVID-19-related hospitalisation and severe COVID-19, which were analysed using logistic regression analyses. Results: A total of 349 PD patients (male 53.6%, age 49 ± 13 years old) were included, and 235 patients (67.3%) were infected. There were no significant differences between COVID-19 and non-COVID-19 patients other than higher proportion of vaccinated patients and slow transporters in the patients who tested positive for COVID-19 (44.7% vs. 28.1%, p = 0.003; 8.7% vs. 1.8%, p = 0.03, respectively). Multivariate analysis showed COVID-19 was associated with vaccination (odds ratio (OR): 1.71, 95% confidence interval (CI): 1.02–2.86) and slow transport type (compared with average transport type, OR: 4.52, 95% CI: 1.01–20.21). Among the patients with infection, 38 (16.2%) patients were hospitalised, 18 (7.7%) patients had severe disease and 9 (3.8%) patients died. In multivariate logistic analysis, both age (OR: 1.04, 95% CI: 1.01–1.07; OR: 1.06, 95% CI: 1.02–1.11) and hyponatremia (OR: 5.44, 95% CI: 1.63–18.13; OR: 6.50, 95% CI: 1.77–23.85) were independent risk factors for COVID-19-related hospitalisation and severe disease. Conclusions: Although vaccinated patients were more likely to have tested positive for COVID-19 infection, they appeared to have less severe infection and less need for hospitalisation. Patients who were older with a history of hyponatremia were more likely to experience adverse outcomes from COVID-19.

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Section: Discussionmentioning

confidence: 99%

COVID-19 and outcomes in Chinese peritoneal dialysis patients

Liao,

Zhou,

et al. 2024

Perit Dial Int

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Syndrome of inappropriate antidiuresis/hyponatremia in COVID-19

Peri,

Naldi,

Norello

et al. 2024

Pituitary

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Hyponatremia is the most frequent electrolyte alteration among hospitalized patients and it has been reported in 20–40% of patients with SARS-CoV-2 (COVID-19) infection. Multiple causes of hyponatremia have been hypothesized in these patients. The syndrome of inappropriate antidiuresis (SIAD) has been considered one of the main reasons leading to hyponatremia in this condition. SIAD can be secondary to cytokines release, in particular IL-6. Positive pressure ventilation can be another cause of hyponatremia due to SIAD. Other possible etiologies of hyponatremia in COVID-19 patients can be related to secondary hypocortisolism, nausea, vomiting, heart and kidney damage. Similar to many other clinical conditions, there is strong evidence that hyponatremia is associated with a worse prognosis also in patients with COVID-19 infection. In particular, hyponatremia has been identified as an independent risk of ICU transfer, need of non-invasive ventilation and death. Hyponatremia in COVID-19 patients is in principle acute and symptomatic and should be treated as such, according to the published guidelines. Therefore, patients should be initially treated with i.v. hypertonic saline (3% NaCl) infusion and serum [Na+] should be frequently monitored, in order to remain within a safe rate of correction. There is evidence showing that serum [Na+] correction is associated with a better outcome in different pathologies, including COVID-19 infection.

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Acute angle-closure glaucoma before, during, and after the outbreak of COVID-19 in China

Mao,

Xie,

et al. 2024

Heliyon

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Relationship between hyponatremia at hospital admission and cardiopulmonary profile at follow-up in patients with SARS-CoV-2 (COVID-19) infection

Cited by 3 publications

References 47 publications

COVID-19 and outcomes in Chinese peritoneal dialysis patients

COVID-19 and outcomes in Chinese peritoneal dialysis patients

Syndrome of inappropriate antidiuresis/hyponatremia in COVID-19

Acute angle-closure glaucoma before, during, and after the outbreak of COVID-19 in China

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