Hypernatremia in Critically Ill COVID-19 Patients: Is it a manifestation of COVID-19 or acquired in the ICU?

Authors : Özgür KILIÇ, Mehmet POLAT, Kamil SANNAH, Melda DİLEK

Pages : 135-146

Doi:10.19127/mbsjohs.1225466

View : 25 | Download : 10

Publication Date : 2023-02-28

Article Type : Research Paper

Abstract :Objective: It has been noted that COVID-19 patients experienced electrolyte problems more frequently, and these disturbances were linked to unfavorable results. The purpose of this study was to investigate the incidence and consequences of hypernatremia in severely ill COVID-19 patients receiving intensive care insert ignore into journalissuearticles values(ICU);. Methods: Retrospective data analysis was done on COVID-19 patients who were admitted to ICUs over a six-month period at two centers. Results: Data from 270 patients were collected in total. 138 insert ignore into journalissuearticles values(51%); patients developed hypernatremia insert ignore into journalissuearticles values(Na >145 mmol/l); during ICU stay. Hypernatremia was observed to be more in older or ventilated patients, whereas less in patients with chronic kidney disease. However, in patients with and without hypernatremia, unfavorable outcomes like length of stay insert ignore into journalissuearticles values(LOS); or mortality were comparable. Frequency of hypertension, septic shock as well as SOFA score, and serum BUN levels were significantly higher in moderate to severe hypernatremic insert ignore into journalissuearticles values(Na ≥150 mmol/l); vs mild hypernatremic insert ignore into journalissuearticles values(Na=146-149 mmol/l); group. Moderate to severe hypernatremia had worse prognosis than the mild group: ICU LOS insert ignore into journalissuearticles values(12 vs 9-day, p=0.033);, ICU mortality insert ignore into journalissuearticles values(86% vs 61%, p=0.001 and 28-day mortality insert ignore into journalissuearticles values(89% vs 68%, p=0.004);. Elevated serum BUN levels and moderate to severe hypernatremia were independent predictors of both ICU and 28-day mortality. Conclusion: Critically ill COVID-19 patients experienced hypernatremia more frequently than expected, suggesting that hypernatremia may be a manifestation of systemic involvement of COVID-19 rather than iatrogenic. Patients with and without hypernatremia were found to have similar outcomes.
Keywords : COVID 19, hypernatremia, critically ill patient, mortality