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感染新冠病毒后第一年易发生低钠血症,且增加再入院率。

Hyponatremia after COVID-19 is frequent in the first year and increases re-admissions.

机构信息

Endocrinology Department, Diabetes and Metabolism Research Unit, Vall d'Hebron University Hospital and Vall d'Hebron Research Institute (VHIR), Universidad Autónoma de Barcelona, Barcelona, Spain.

Infectious Diseases Department, Vall d'Hebrón University Hospital, Global Health Program from the Catalan Health Institute (PROSICS), Universitat Autònoma de Barcelona, Barcelona, Spain.

出版信息

Sci Rep. 2024 Jan 5;14(1):595. doi: 10.1038/s41598-023-50970-z.

Abstract

Hyponatremia on admission has been related to worse outcomes in patients with COVID-19 infection. However, little is known about the frequency and the associated risk factors of hyponatremia after COVID-19 discharge. We performed an observational 24-month follow-up study of patients admitted during the first COVID-19 wave. Kaplan-Meier curves and Cox proportional hazard models were used to assess the main variables in predicting hyponatremia on follow-up (HYPO-FU). A total of 161 out of 683 (24.4%) developed HYPO-FU. The group with HYPO-FU comprised of more men [(62.3%) vs. (49.2%); p < 0.01], older [65.6 ± 18.2 vs. 60.3 ± 17.0; p < 0.01] and more frequently re-admitted [(16.2%) vs. (3.8%); p < 0.01). The rate of HYPO-FU was higher in the first year 23.6 per 100 individuals per year. After Cox regression analysis, the independent risk factors of HYPO-FU were diabetes [OR 2.12, IC 95% (1.48-3.04)], hypertension [OR 2.18, IC 95% (1.53-3.12)], heart failure [OR 3.34, IC 95% (1.72-6.48)] and invasive ventilation support requirement [OR: 2.38, IC 95% (1.63-3.50)]. To conclude, HYPO-FU was frequent in the first year after COVID-19 infection, and the risk was higher in older men with comorbidities, increasing rehospitalisation. Further studies aimed at evaluating the beneficial effects of correcting hyponatremia in these patients are warranted.

摘要

入院时低钠血症与 COVID-19 感染患者的预后较差有关。然而,关于 COVID-19 出院后低钠血症的频率和相关危险因素知之甚少。我们对第一波 COVID-19 期间入院的患者进行了一项观察性的 24 个月随访研究。Kaplan-Meier 曲线和 Cox 比例风险模型用于评估预测随访时低钠血症的主要变量(HYPO-FU)。在 683 例患者中,有 161 例(24.4%)发生了 HYPO-FU。HYPO-FU 组的男性比例较高[62.3%比 49.2%;p<0.01],年龄较大[65.6±18.2 比 60.3±17.0;p<0.01],再次入院的频率更高[16.2%比 3.8%;p<0.01]。第一年的 HYPO-FU 发生率为每 100 人每年 23.6 例。经过 Cox 回归分析,HYPO-FU 的独立危险因素是糖尿病[OR 2.12,95%CI(1.48-3.04)]、高血压[OR 2.18,95%CI(1.53-3.12)]、心力衰竭[OR 3.34,95%CI(1.72-6.48)]和有创通气支持的需求[OR:2.38,95%CI(1.63-3.50)]。总之,COVID-19 感染后第一年 HYPO-FU 很常见,在伴有合并症的老年男性中风险更高,再次住院的风险增加。需要进一步研究评估纠正这些患者低钠血症的有益效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccba/10770325/f51610d567a6/41598_2023_50970_Fig1_HTML.jpg

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