1
|
Achinger SG, Kumar A, Tsalatsanis A. COVID-19 and Incidence of Acute and Chronic Hyponatremia: A Matched Cohort Study. Kidney Med 2024; 6:100750. [PMID: 38259724 PMCID: PMC10801209 DOI: 10.1016/j.xkme.2023.100750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024] Open
Affiliation(s)
- Steven G. Achinger
- Department of Nephrology and Hypertension, Morsani College of Medicine, University of South Florida Health, Tampa, FL
- Department of Nephrology, Watson Clinic, LLP, Lakeland, FL
| | - Ambuj Kumar
- Research Methodology and Biostatistics Core, Office of Research, Department of Internal Medicine, Morsani College of Medicine, University of South Florida Health, Tampa, FL
| | - Athanasios Tsalatsanis
- Research Methodology and Biostatistics Core, Office of Research, Department of Internal Medicine, Morsani College of Medicine, University of South Florida Health, Tampa, FL
| |
Collapse
|
2
|
Regolisti G, Rebora P, Occhino G, Lieti G, Molon G, Maloberti A, Algeri M, Giannattasio C, Valsecchi MG, Genovesi S. Elevated Serum Urea-to-Creatinine Ratio and In-Hospital Death in Patients with Hyponatremia Hospitalized for COVID-19. Biomedicines 2023; 11:1555. [PMID: 37371650 DOI: 10.3390/biomedicines11061555] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Hyponatremia is associated with adverse outcomes in hospitalized patients. An elevated value of the serum urea-to-creatinine ratio (UCR) has been proposed as a proxy of hypovolemia. The aim of this study was to investigate the relationship between the UCR and in-hospital death in patients hospitalized with COVID-19 and hyponatremia. We studied 258 patients admitted for COVID-19 between January 2020 and May 2021 with serum sodium at < 135 mmol/L. The primary end-point was all-cause mortality. A 5-unit increase in the serum UCR during hospital stays was associated with an 8% increase in the hazard of all-cause death (HR = 1.08, 95% CI: 1.03-1.14, p = 0.001) after adjusting for potential confounders. In patients with a UCR > 40 at baseline, a > 10 mmol/L increase in serum sodium values within the first week of hospitalization was associated with higher odds of in-hospital death (OR = 2.93, 95% CI: 1.03-8.36, p = 0.044) compared to patients who experienced a < 10 mmol/L change. This was not observed in patients with a UCR < 40. Hypovolemia developing during hospital stays in COVID-19 patients with hyponatremia detected at hospital admission bears an adverse prognostic impact. Moreover, in hypovolemic patients, a > 10 mmol/L increase in serum sodium within the first week of hospital stays may further worsen the in-hospital prognosis.
Collapse
Affiliation(s)
- Giuseppe Regolisti
- Clinica e Immunologia Medica, Azienda Ospedaliero-Universitaria di Parma, 43100 Parma, Italy
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Paola Rebora
- Bicocca Bioinformatics, Biostatistics and Bioimaging Centre-B4, School of Medicine and Surgery, Milano-Bicocca University, 20126 Milan, Italy
| | - Giuseppe Occhino
- Bicocca Bioinformatics, Biostatistics and Bioimaging Centre-B4, School of Medicine and Surgery, Milano-Bicocca University, 20126 Milan, Italy
| | - Giulia Lieti
- School of Medicine and Surgery, Milano-Bicocca University, 20126 Milan, Italy
| | - Giulio Molon
- Cardiology Department, Istituto Ricovero Cura Carattere Scientifico (IRCCS) Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy
| | - Alessandro Maloberti
- School of Medicine and Surgery, Milano-Bicocca University, 20126 Milan, Italy
- Cardiology 4, Cardio Center, ASST-GOM Niguarda, Niguarda Hospital, 20162 Milan, Italy
| | - Michela Algeri
- Cardiology 4, Cardio Center, ASST-GOM Niguarda, Niguarda Hospital, 20162 Milan, Italy
| | - Cristina Giannattasio
- School of Medicine and Surgery, Milano-Bicocca University, 20126 Milan, Italy
- Cardiology 4, Cardio Center, ASST-GOM Niguarda, Niguarda Hospital, 20162 Milan, Italy
| | - Maria Grazia Valsecchi
- Bicocca Bioinformatics, Biostatistics and Bioimaging Centre-B4, School of Medicine and Surgery, Milano-Bicocca University, 20126 Milan, Italy
| | - Simonetta Genovesi
- School of Medicine and Surgery, Milano-Bicocca University, 20126 Milan, Italy
- Istituto Auxologico Italiano, Istituto Ricovero Cura Carattere Scientifico (IRCCS), 20135 Milan, Italy
| |
Collapse
|