Prognostic Impact of Hyponatremia and Hypernatremia in COVID-19 Pneumonia. A HOPE-COVID-19 (Health Outcome Predictive Evaluation for COVID-19) Registry Analysis

• Main Authors: Jorge Gabriel Ruiz-Sánchez, Ivan J. Núñez-Gil, Martin Cuesta, Miguel A. Rubio, Charbel Maroun-Eid, Ramón Arroyo-Espliguero, Rodolfo Romero, Victor Manuel Becerra-Muñoz, Aitor Uribarri, Gisela Feltes, Daniela Trabattoni, María Molina, Marcos García Aguado, Martino Pepe, Enrico Cerrato, Emilio Alfonso, Alex Fernando Castro Mejía, Sergio Raposeiras Roubin, Luis Buzón, Elvira Bondia, Francisco Marin, Javier López Pais, Mohammad Abumayyaleh, Fabrizio D’Ascenzo, Elisa Rondano, Jia Huang, Cristina Fernandez-Perez, Carlos Macaya, Paz de Miguel Novoa, Alfonso L. Calle-Pascual, Vicente Estrada Perez, Isabelle Runkle, HOPE COVID-19 investigators
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2020-11-01
• Series: Frontiers in Endocrinology
• Subjects: hyponatremia; hypernatremia; COVID-19; SARS-COV2; mortality; sepsis
• Online Access: https://www.frontiersin.org/articles/10.3389/fendo.2020.599255/full

Dysnatremia is associated with increased mortality in patients with community-acquired pneumonia. SARS-COV2 (Severe-acute-respiratory syndrome caused by Coronavirus-type 2) pneumonia can be fatal. The aim of this study was to ascertain whether admittance dysnatremia is associated with mortality, sepsis, or intensive therapy (IT) in patients hospitalized with SARS-COV2 pneumonia. This is a retrospective study of the HOPE-COVID-19 registry, with data collected from January 1th through April 31th, 2020. We selected all hospitalized adult patients with RT-PCR-confirmed SARS-COV2 pneumonia and a registered admission serum sodium level (SNa). Patients were classified as hyponatremic (SNa <135 mmol/L), eunatremic (SNa 135–145 mmol/L), or hypernatremic (SNa >145 mmol/L). Multivariable analyses were performed to elucidate independent relationships of admission hyponatremia and hypernatremia, with mortality, sepsis, or IT during hospitalization. Four thousand six hundred sixty-four patients were analyzed, median age 66 (52–77), 58% males. Death occurred in 988 (21.2%) patients, sepsis was diagnosed in 551 (12%) and IT in 838 (18.4%). Hyponatremia was present in 957/4,664 (20.5%) patients, and hypernatremia in 174/4,664 (3.7%). Both hyponatremia and hypernatremia were associated with mortality and sepsis. Only hyponatremia was associated with IT. In conclusion, hyponatremia and hypernatremia at admission are factors independently associated with mortality and sepsis in patients hospitalized with SARS-COV2 pneumonia.Clinical Trial Registrationhttps://clinicaltrials.gov/ct2/show/NCT04334291, NCT04334291.