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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...

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Autores principales: 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.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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.
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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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