1. v
Figure 1. Sample included in this study
Gonzalo Francisco Miranda 1 , Manuel Jimenez, Anggi Tadeo 2
1
Endocrinology Unit, Dos de Mayo Hospital- Lima, Perú . 2 Universidad San Martin De Porres
Hyponatremia as a prognostic factor of mortality in COVID-19 at the Hospital Nacional Dos de Mayo – Lima, Peru
Discussion:
• Hyponatremia is a poor prognostic factor as an indicator of
hospitalization and increased mortality in COVID-19 and this can be
explained as hyponatremia may be the result of a high concentration
of interleukin-6, one of the most important cytokines involved in
COVID-19 injury.
• Factors associated with hyponatremia such as severe COVID,
elevated procalcitonin levels, hypoalbuminemia and elevated lactate
levels have been picked up in other studies in patients with COVID-19
as independent poor prognostic factors at the hospital level.
• Our result support the fact that sodium levels in hospitalized patients
with COVID-19 are a tool for early identification of patients at high risk
for poor outcome.
• It should be noted that the diagnosis of SIADH may be
underdiagnosed since in none of the evaluated patients was the
diagnosis of inappropriate antidiuretic hormone secretion syndrome
recorded
• The main advantage of the study is that all included patients were
admitted with PCR-confirmed COVID-19.
Conclusion:
• The presence of severe hyponatremia on hospital admission was
associated with higher mortality in patients with SARS-CoV-2.
• COVID-19 infection may aggravate the picture of hyponatremia and
the diagnosis of SIHAD may be under-diagnosed.
• Therefore, physicians treating COVID-19 pneumonia should be aware
that patients admitted with hyponatremia have a worse outcome than
patients presenting with eunatremia.
• Interventional studies are needed to test whether correction of
hyponatremia on admission could improve clinical outcome.
Table 2: Logistic regression analysis selected best model by Forward
Background:
Hyponatremia is the most common electrolyte disorder founded among hospitalized patients
and is defined with values < 135 mEq/L. Studies have reported that, in most cases, patients
with community-acquired pneumonia presents mild hyponatremia. Severe Acute Respiratory
Syndrome Coronavirus – 2 infections have a variable clinical picture: from asymptomatic
patients to patients who end up in the Intensive Care Unit (UCI) with mechanical ventilation
due to acute respiratory distress syndrome (ARDS) that can be accompanied by multi-organ
failure and, finally, death.
Dysnatremias are risk factors for poor prognosis and increased mortality in patients admitted
to the ICU. The altered blood sodium level plays an important role in the recovery of those
patients hospitalized for pneumonia due to COVID-19 and, therefore, the correction should
be early and timely. Despite international evidence, little research has been done in Peru
about the relationship between water and electrolyte disorders and pneumonia caused by
the new coronavirus.
Objective:
To establish if hyponatremia is a prognostic factor of mortality in patients with COVID-19
diagnosis
Material and methods:
The sample consisted of 185 medical records of patients with a COVID-19 diagnosis, which
has been seen between June 2020 and February 2021 an observational, cohort and
retrospective study. We recorded epidemiological, demographic, clinical, biochemical and
radiological variables of SARS-CoV-2 infection and hyponatremia at the time of diagnosis
during hospitalization.
Descriptive analysis was used for main variables, Chi square tests, OR calculation and
confidence interval were used to assess the statistical association of the variables. Finally, a
logistic regression analysis was performed to evaluate confusing variables.
Table 1: Mortality according to sodium
ODP316
