Abstract
Objective:To investigate the occurrence of disorders of water and sodium balance in COVID-19 in our clinic.Methods:In this retrospective chart review, patients were included if a polymerase chain test result for SARS-CoV-2 was obtained and if at least one plasma sodium concentration measurement was obtained during the period from March to June 2020. The occurrences of hyponatremia and hypernatremia were compared between 193 SARS-CoV-2-positive and 138 SARS-CoV-2-negative patients. A χ² test was used to determine statistical significance, and the corresponding p-values were calculated.Results:Hypernatremia was significantly more frequently observed in COVID-19 patients, in 38% (74 of 193), versus only 8% in SARS-CoV-2-negative patients (11 of 138) (p < 0.01). Hyponatremia was observed in 34% of the included COVID-19 patients (65 of 193) versus 24% of SARS-CoV-2-negative patients (33 of 138). In 12% of all COVID-19 patients (23 of 193), both hyponatremia and hypernatremia were observed at some point during their admission. Among the non-COVID-19 patients, only 4% showed these plasma sodium concentration fluctuations (5 of 138). The mortality rate among the hospitalized COVID-19 patients was 23% (45 of 193). Correcting for double-counting, more than 71% (32 of 45) of the deceased COVID-19 patients developed dysnatremia (hyponatremia, hypernatremia or both) versus 57% (84 out of 148) of the surviving COVID-19 patients.Conclusion:Disorders of water and sodium balance—and especially hypernatremia—seem to be a common occurrence in COVID-19 patients. This has important implications for the treatment of COVID-19 patients.
Highlights
The ongoing pandemic known as coronavirus disease 2019 (COVID-19), which is caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has swept across the globe in a matter of weeks and has stirred healthcare professionals and governments everywhere to the highest degree.[1,2] Its impact on everyday life, ranging from social distancing to the widespread ban on social gatherings, is unmistakable and profound
For this retrospective chart review, we have used patient data collected for the COvid-19 PAtients CHaracteristics (COVPACH) study, which has registered the laboratory test results of all hospitalized COVID-19 patients in University Medical Center Utrecht (UMCU), including patients admitted to the intensive care unit (ICU), during the period March to June 2020
Hypernatremia was observed in 38% of the included COVID19 patients (74 of 193) versus in only 8% of the SARS-CoV2-negative patients (11 of 138), which is a strong significant difference (p < 0.01)
Summary
The ongoing pandemic known as coronavirus disease 2019 (COVID-19), which is caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has swept across the globe in a matter of weeks and has stirred healthcare professionals and governments everywhere to the highest degree.[1,2] Its impact on everyday life, ranging from social distancing to the widespread ban on social gatherings, is unmistakable and profound. A growing body of evidence shows that COVID19 is accompanied by several extra-pulmonary phenomena, such as disorders of the water and sodium balance.[5,6,7]
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