SFEBES2022 Poster Presentations Metabolism, Obesity and Diabetes (96 abstracts)
‘Don’t Let them dry’—Hyponatraemia in Covid-19 (a real-world analysis)
Ahtisham Alikhan 1 , Samuel Westall 2 , Abidullah Khan 2 , Heather Sullivan 2 , Matus Kalavsky 2 , Rahman Olusoji 2 , Hana Kolackova 2 , Sumudu Bujawansa 2 & Ram Prakash Narayanan 2
1Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; 2St Helens and Knowsley Teaching Hospitals NHS Trust, St Helens, United Kingdom
Background: The aetiology of hyponatraemia in SARS-CoV-2 (COVID-19) is complex. Early studies have suggested a syndrome of inappropriate anti-diuretic hormone picture. We undertook a real-world retrospective analysis of patients with hyponatraemia and COVID-19 hospitalised over a 12-month period and evaluated practice against European hyponatraemia guidelines to see if initial investigations and management were appropriate. Additionally, we evaluated whether hyponatraemia in COVID-19 was associated with adverse outcomes and other associations with poor prognosis in this cohort.
Methods: We retrospectively analysed data from 229 patients with confirmed serum sodium <130 mmol/l and positive reverse-transcriptase polymerase chain reaction COVID-19 test over a 12-month period. Additionally, we used binary logistic regression to evaluate associations between patient characteristics and mortality.
Results: Records of volume status (46.7%), serum osmolality (29.3%), urine osmolality and sodium (24.5%), serum cortisol (22.3%), and thyroid stimulating hormone (52.8%) were sub-optimal. Hypovolaemia was the prominent aetiology of hyponatraemia in COVID-19 patients. Thirty-day mortality (34.5%) in those with hyponatraemia and COVID-19 was similar to overall 30-day mortality for COVID-19 patients attending hospital over the same period (34.1%). Logistic regression demonstrated female gender (OR 3.88, 95% CI 1.78–8.46, P<.001), lower nadir sodium (OR .797, 95% CI .702–.905, P<.001) and higher Charlson comorbidity index (OR 1.355, 95% CI 1.159–1.583, P<.001) were associated with increased likelihood of mortality.
Discussion: In those with COVID-19, hyponatraemia was not associated with increased 30-day mortality in comparison with patients who had normal sodium levels. Recognition of hypovolaemia as a common presentation of hyponatraemia in patients with COVID-19 is important to prevent inappropriate fluid restriction and ensure timely fluid management in these patients. Female gender, lower nadir sodium and the number of comorbidities were predictors of poor outcomes in our cohort. Excess mortality seen in females is likely explained by the higher mean age (76.8 vs 72.1).
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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