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Epidemiology and Outcomes of Hypernatraemia in Patients with COVID-19—A Territory-Wide Study in Hong Kong
Background: Dysnatraemias are commonly reported in COVID-19. However, the clinical epidemiology of hypernatraemia and its impact on clinical outcomes in relation to different variants of SARS-CoV-2, especially the prevailing Omicron variant, remain unclear. Methods: This was a territory-wide retrosp...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9918136/ https://www.ncbi.nlm.nih.gov/pubmed/36769690 http://dx.doi.org/10.3390/jcm12031042 |
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author | So, Benjamin Y. F. Wong, Chun Ka Chan, Gordon Chun Kau Ng, Jack Kit Chung Lui, Grace Chung Yan Szeto, Cheuk Chun Hung, Ivan Fan Ngai Tse, Hung Fat Tang, Sydney C. W. Chan, Tak Mao Chow, Kai Ming Yap, Desmond Y. H. |
author_facet | So, Benjamin Y. F. Wong, Chun Ka Chan, Gordon Chun Kau Ng, Jack Kit Chung Lui, Grace Chung Yan Szeto, Cheuk Chun Hung, Ivan Fan Ngai Tse, Hung Fat Tang, Sydney C. W. Chan, Tak Mao Chow, Kai Ming Yap, Desmond Y. H. |
author_sort | So, Benjamin Y. F. |
collection | PubMed |
description | Background: Dysnatraemias are commonly reported in COVID-19. However, the clinical epidemiology of hypernatraemia and its impact on clinical outcomes in relation to different variants of SARS-CoV-2, especially the prevailing Omicron variant, remain unclear. Methods: This was a territory-wide retrospective study to investigate the clinical epidemiology and outcomes of COVID-19 patients with hypernatraemia at presentation during the period from 1 January 2020 to 31 March 2022. The primary outcome was 30-day mortality. Key secondary outcomes included rates of hospitalization and ICU admission, and costs of hospitalization. Results: In this study, 53,415 adult COVID-19 patients were included for analysis. Hypernatraemia was observed in 2688 (5.0%) patients at presentation, of which most cases (99.2%) occurred during the local “5th wave” dominated by the Omicron BA.2 variant. Risk factors for hypernatraemia at presentation included age, institutionalization, congestive heart failure, dementia, higher SARS-CoV-2 Ct value, white cell count, C-reactive protein and lower eGFR and albumin levels (p < 0.001 for all). Patients with hypernatraemia showed significantly higher 30-day mortality (32.0% vs. 5.7%, p < 0.001) and longer lengths of stay (12.9 ± 10.9 vs. 11.5 ± 12.1 days, p < 0.001) compared with those with normonatraemia. Multivariate analysis revealed hypernatraemia at presentation as an independent predictor for 30-day mortality (aHR 1.32, 95% CI 1.14–1.53, p < 0.001) and prolonged hospital stays (OR 1.55, 95% CI 1.17–2.05, p = 0.002). Conclusions: Hypernatraemia is common among COVID-19 patients, especially among institutionalized older adults with cognitive impairment and other comorbidities during large-scale outbreaks during the Omicron era. Hypernatraemia is associated with unfavourable outcomes and increased healthcare utilization. |
format | Online Article Text |
id | pubmed-9918136 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-99181362023-02-11 Epidemiology and Outcomes of Hypernatraemia in Patients with COVID-19—A Territory-Wide Study in Hong Kong So, Benjamin Y. F. Wong, Chun Ka Chan, Gordon Chun Kau Ng, Jack Kit Chung Lui, Grace Chung Yan Szeto, Cheuk Chun Hung, Ivan Fan Ngai Tse, Hung Fat Tang, Sydney C. W. Chan, Tak Mao Chow, Kai Ming Yap, Desmond Y. H. J Clin Med Article Background: Dysnatraemias are commonly reported in COVID-19. However, the clinical epidemiology of hypernatraemia and its impact on clinical outcomes in relation to different variants of SARS-CoV-2, especially the prevailing Omicron variant, remain unclear. Methods: This was a territory-wide retrospective study to investigate the clinical epidemiology and outcomes of COVID-19 patients with hypernatraemia at presentation during the period from 1 January 2020 to 31 March 2022. The primary outcome was 30-day mortality. Key secondary outcomes included rates of hospitalization and ICU admission, and costs of hospitalization. Results: In this study, 53,415 adult COVID-19 patients were included for analysis. Hypernatraemia was observed in 2688 (5.0%) patients at presentation, of which most cases (99.2%) occurred during the local “5th wave” dominated by the Omicron BA.2 variant. Risk factors for hypernatraemia at presentation included age, institutionalization, congestive heart failure, dementia, higher SARS-CoV-2 Ct value, white cell count, C-reactive protein and lower eGFR and albumin levels (p < 0.001 for all). Patients with hypernatraemia showed significantly higher 30-day mortality (32.0% vs. 5.7%, p < 0.001) and longer lengths of stay (12.9 ± 10.9 vs. 11.5 ± 12.1 days, p < 0.001) compared with those with normonatraemia. Multivariate analysis revealed hypernatraemia at presentation as an independent predictor for 30-day mortality (aHR 1.32, 95% CI 1.14–1.53, p < 0.001) and prolonged hospital stays (OR 1.55, 95% CI 1.17–2.05, p = 0.002). Conclusions: Hypernatraemia is common among COVID-19 patients, especially among institutionalized older adults with cognitive impairment and other comorbidities during large-scale outbreaks during the Omicron era. Hypernatraemia is associated with unfavourable outcomes and increased healthcare utilization. MDPI 2023-01-29 /pmc/articles/PMC9918136/ /pubmed/36769690 http://dx.doi.org/10.3390/jcm12031042 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article So, Benjamin Y. F. Wong, Chun Ka Chan, Gordon Chun Kau Ng, Jack Kit Chung Lui, Grace Chung Yan Szeto, Cheuk Chun Hung, Ivan Fan Ngai Tse, Hung Fat Tang, Sydney C. W. Chan, Tak Mao Chow, Kai Ming Yap, Desmond Y. H. Epidemiology and Outcomes of Hypernatraemia in Patients with COVID-19—A Territory-Wide Study in Hong Kong |
title | Epidemiology and Outcomes of Hypernatraemia in Patients with COVID-19—A Territory-Wide Study in Hong Kong |
title_full | Epidemiology and Outcomes of Hypernatraemia in Patients with COVID-19—A Territory-Wide Study in Hong Kong |
title_fullStr | Epidemiology and Outcomes of Hypernatraemia in Patients with COVID-19—A Territory-Wide Study in Hong Kong |
title_full_unstemmed | Epidemiology and Outcomes of Hypernatraemia in Patients with COVID-19—A Territory-Wide Study in Hong Kong |
title_short | Epidemiology and Outcomes of Hypernatraemia in Patients with COVID-19—A Territory-Wide Study in Hong Kong |
title_sort | epidemiology and outcomes of hypernatraemia in patients with covid-19—a territory-wide study in hong kong |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9918136/ https://www.ncbi.nlm.nih.gov/pubmed/36769690 http://dx.doi.org/10.3390/jcm12031042 |
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