Hyponatremia is associated with poor outcome in COVID-19
Hugo De Carvalho, Thibault Letellier, Matilde Karakachoff, Geoffrey Desvaux, Hélène Caillon, Emmanuelle Papuchon, Maxime Bentoumi-Loaec, Nesrine Benaouicha, Emmanuel Canet, Guillaume Chapelet, Paul Le Turnier, Emmanuel Montassier, Armine Rouhani, Nicolas Goffinet, Lucile Figueres
Abstract
AIM: Our objective was to describe the impact of hyponatremia on the outcomes of COVID-19 patients [outcomes selected: intensive care unit (ICU) admission, mechanical ventilation or death]. METHODS: (qualitative variables) and Student's T tests (quantitative variables) were used to compare the two groups. A multiple logistic regression model was used to explore the association between patients' clinical data and outcomes. RESULTS: Hyponatremia was frequent but generally mild. There were more male patients in the hyponatremic group (p = 0.014). Pulmonary lesions on the first thoracic CT-scan performed during hospitalization were significantly more extensive in the hyponatremic group (p = 0.010). ICU admission, mechanical ventilation or death were significantly more frequent in hyponatremic compared to normonatremic patients (37 versus 14%; p < 0.001; 17 versus 6%; p = 0.003; 18 versus 9%, p = 0.042, respectively). Hyponatremia was an independent predictor of adverse outcomes (adjusted Odds-ratio: 2.77 [1.26-6.15, p = 0.011]). CONCLUSIONS: Our study showed an independent relationship between hyponatremia at admission and transfer to ICU, use of mechanical ventilation or death in COVID-19 patients. Hyponatremia may reflect the severity of underlying pulmonary lesions. Our results support the use of sodium levels as a simple bedside screening tool for the early identification of SARS-CoV-2 infected patients at high risk of poor outcome.