[新冠病毒病患者的电解质紊乱及其与发病率和死亡率的关联]

[Dysnatremias and their association with morbidity and mortality in patients with COVID- 19].

作者信息

Núñez-Martínez Francisco Javier, Orozco-Juárez Karla, Chávez-Lárraga Alejandro de Jesús, Velasco-Santos Jorge Isaac

机构信息

Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No.1, Servicio de Medicina Interna. León, Guanajuato, México.

Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar No. 7, Servicio de Medicina Familiar. San Juan del Río, Querétaro, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2022 Aug 31;60(5):548-555.

PMID:36048807

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10396052/

Abstract

BACKGROUND

Coronavirus disease 2019 (COVID-19) has provoked one of the greatest health crises of our time, which is why risk stratification at the time of hospitalization is essential to identify in good time patients with high morbidity and mortality risk. Dysnatremia as an independent predictor of mortality in patients with COVID-19 has recently become relevant.

OBJECTIVE

To find out if there is an association of dysnatremia with 28-day mortality, and as secondary objectives, its association with hospital stay, invasive mechanical ventilation (IMV) requirement and presence of acute kidney injury (AKI) during hospital stay.

MATERIAL AND METHODS

Retrospective, descriptive and analytical cohort study. All consecutive patients of 16 years or older of any gender, admitted to a third level hospital from March 1, 2020 to March 2021, who have a diagnosis of COVID-19 with positive PCR were included.

RESULTS

The study included a total of 722 patients. The prevalence of dysnatremia was as follows: 18 patients presented hypernatremia (2.49%) and 153 hyponatremia (21.19%). The presence of hypernatremia once sodium was corrected for glucose was associated with higher mortality (p < 0.05, OR 3.446; 95% CI 1.776-6.688), an increased probability of presenting AKI (p <0.05, OR 2.985; 95% CI 1.718-5.184) and a greater requirement for IMV (p < 0.05, OR 1.945; 95% CI 1.701-5.098).

CONCLUSIONS

Hypernatremia was associated with higher mortality, higher risk of presenting AKI and the requirement for IMV during hospitalization.

摘要

背景

2019冠状病毒病（COVID-19）引发了我们这个时代最严重的健康危机之一，这就是为什么住院时进行风险分层对于及时识别高发病率和高死亡率风险的患者至关重要。低钠血症作为COVID-19患者死亡率的独立预测因素，最近受到了关注。

目的

探究低钠血症与28天死亡率之间是否存在关联，作为次要目的，还要探究其与住院时间、有创机械通气（IMV）需求以及住院期间急性肾损伤（AKI）的存在之间的关联。

材料与方法

回顾性、描述性和分析性队列研究。纳入2020年3月1日至2021年3月在一家三级医院住院的所有16岁及以上、任何性别的连续患者，这些患者经PCR检测确诊为COVID-19。

结果

该研究共纳入722例患者。低钠血症的患病率如下：18例患者出现高钠血症（2.49%），153例患者出现低钠血症（21.19%）。校正血糖后的高钠血症与较高的死亡率相关（p<0.05，OR 3.446；95%CI 1.776 - 6.688），出现AKI的概率增加（p<0.05，OR 2.985；95%CI 1.718 - 5.184），对IMV的需求更大（p<0.05，OR 1.945；95%CI 1.701 - 5.098）。