Anees Muhammad, Raza Muhammad, Farooq Omair, Mumtaz Asim
Prof. Dr. Muhammad Anees, FCPS. Consultant Nephrologist, Farooq Hospital Westwood Branch, Lahore, Pakistan.
Dr. Muhammad Raza, MBBS, Farooq Hospital Westwood Branch, Lahore, Pakistan.
Pak J Med Sci. 2023 Jan-Feb;39(1):274-279. doi: 10.12669/pjms.39.1.5466.
OBJECTIVES: To determine the risk factors for Hyponatremia in Coronavirus disease 2019 (COVID-19) patients. METHODS: Medical records of all patients admitted in COVID-19 Isolation Intensive Care Unit of Farooq Hospital Westwood Branch, Lahore from 1 July to 30 September, 2020 were retrospectively reviewed. Patients with confirmed diagnosis of COVID-19 by Real Time Polymerase Chain Reaction (RT-PCR) and having Hyponatremia (serum Sodium (s/Na <135mEq/L) were included, patients with Eunatremia (s/Na within 135 - 145mEq/L) were taken as control while subjects with Hypernatremia (s/Na >145mEq/L) at admission, incomplete medical records and pregnant females were excluded from the study. Demographic, clinical and laboratory data at time of admission in hospital was extracted. RESULTS: Of 182 included patients, 79.1% (n=144) were male 40.7% (n=74) had Diabetes Mellitus (DM) and 44.5% (n=81) were hypertensive. Forty seven percent (n=86) patients had Hyponatremia while 52.7% (n=96) were eunatremic. Forty nine percent (n=90) patients had Acute Kidney Injury (AKI) and 4.9% (n=9) patients died. Risk factors for Hyponatremia were age >60 years (OR=2.52, =0.006); DM (OR=2.79, =0.001); Hypoxemia (OR=3.74, <0.001); Lymphopenia (OR=7.62, <0.009); Hypoalbuminemia (OR=9.15, <0.001); high serum Ferritin (OR=4.46, <0.001), high Neutrophil to Lymphocyte Ratio (NLR) (OR=3.58, p<0.001) and AKI (OR=3.40, <0.001). CONCLUSIONS: Hyponatremia was common in COVID-19 hospitalized patients. Increasing age, DM, Hypoxemia, Hypoalbuminemia, high serum Ferritin and AKI were the most significant risk factors for Hyponatremia. Hyponatremic patients had comparatively higher mortality than Eunatremic patients.
目的:确定2019冠状病毒病(COVID-19)患者低钠血症的危险因素。 方法:回顾性分析2020年7月1日至9月30日在拉合尔法鲁克医院韦斯特伍德分院COVID-19隔离重症监护病房收治的所有患者的病历。纳入经实时聚合酶链反应(RT-PCR)确诊为COVID-19且患有低钠血症(血清钠(s/Na)<135mEq/L)的患者,将血钠正常(s/Na在135 - 145mEq/L之间)的患者作为对照,排除入院时高钠血症(s/Na>145mEq/L)、病历不完整的患者以及孕妇。提取患者入院时的人口统计学、临床和实验室数据。 结果:在182例纳入患者中,79.1%(n = 144)为男性,40.7%(n = 74)患有糖尿病(DM),44.5%(n = 81)患有高血压。47%(n = 86)的患者患有低钠血症,而52.7%(n = 96)的患者血钠正常。49%(n = 90)的患者患有急性肾损伤(AKI),4.9%(n = 9)的患者死亡。低钠血症的危险因素包括年龄>60岁(OR = 2.52,P = 0.006);糖尿病(OR = 2.79,P = 0.001);低氧血症(OR = 3.74,P<0.001);淋巴细胞减少(OR = 7.62,P<0.009);低白蛋白血症(OR = 9.15,P<0.001);高血清铁蛋白(OR = 4.46,P<0.001)、高中性粒细胞与淋巴细胞比值(NLR)(OR = 3.58,P<0.001)和急性肾损伤(OR = 3.40,P<0.001)。 结论:低钠血症在COVID-19住院患者中很常见。年龄增加、糖尿病、低氧血症、低白蛋白血症、高血清铁蛋白和急性肾损伤是低钠血症最重要的危险因素。低钠血症患者的死亡率相对高于血钠正常的患者。
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