Hyponatremia At Admission in Hospitalized Patients With Covid-19: Risk Factors and Impact on Prognosis

Background: electrolyte disorders, particularly hyponatremia, have been reported in aconsiderable number of patients with coronavirus disease 2019 (covid-19).objective: the current study aims to evaluate the risk factors, symptoms, and prognosis ofhyponatremia in hospitalized patients with covid-19.methods: in this retrospective cohort study, 467 patients with covid-19 were divided into4 groups based on the sodium level at the time of admission: normal, mild hyponatremia,moderate hyponatremia, and severe hyponatremia. symptoms, laboratory findings,and prognosis were compared among these groups. the risk factors for the occurrenceof moderate/severe hyponatremia and the association of hyponatremia with in-hospitalmortality were investigated using logistic regression analysis.findings: hyponatremia was diagnosed in 60% of the patients. the prevalence of mild,moderate, and severe hyponatremia was 80.7%, 15.1%, and 4.2%, respectively. theseverity of the clinical symptoms and level of hypoxia showed no significant differencebetween the groups. white blood cells count was significantly higher and lymphocytepercentage was significantly lower in hyponatremia groups compared to the normal group.the history of chronic kidney disease was an independent risk factor for the moderate/severe hyponatremia (adjusted or=5.11, 95%ci: 1.72-15.2, p=0.003). after adjustmentof different risk factors, moderate/severe hyponatremia remained a significant independentrisk factor for in-hospital mortality (or=2.58, 95%ci: 1.13-5.88, p=0.024).conclusion: hyponatremia is prevalent in covid-19 patients. however, it is notdefinitely associated with severity of covid-19 at the time of admission. moderate/severehyponatremia is associated with higher in-hospital mortality rate despite the similarity ofdisease severity between the sodium groups.