File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Epidemiology and Outcomes of Hypernatraemia in Patients with COVID-19-A Territory-Wide Study in Hong Kong

TitleEpidemiology and Outcomes of Hypernatraemia in Patients with COVID-19-A Territory-Wide Study in Hong Kong
Authors
KeywordsCOVID-19
epidemiology
hypernatraemia
outcomes
sodium
Issue Date29-Jan-2023
PublisherMDPI
Citation
Journal of Clinical Medicine, 2023, v. 12, n. 3 How to Cite?
Abstract

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.


Persistent Identifierhttp://hdl.handle.net/10722/329053
ISSN
2023 Impact Factor: 3.0
2023 SCImago Journal Rankings: 0.882
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorSo, BYF-
dc.contributor.authorWong, CK-
dc.contributor.authorChan, GCK-
dc.contributor.authorNg, JKC-
dc.contributor.authorLui, GCY-
dc.contributor.authorSzeto, CC-
dc.contributor.authorHung, IFN-
dc.contributor.authorTse, HF-
dc.contributor.authorTang, SCW-
dc.contributor.authorChan, TM-
dc.contributor.authorChow, KM-
dc.contributor.authorYap, DYH-
dc.date.accessioned2023-08-05T07:54:55Z-
dc.date.available2023-08-05T07:54:55Z-
dc.date.issued2023-01-29-
dc.identifier.citationJournal of Clinical Medicine, 2023, v. 12, n. 3-
dc.identifier.issn2077-0383-
dc.identifier.urihttp://hdl.handle.net/10722/329053-
dc.description.abstract<p>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.</p>-
dc.languageeng-
dc.publisherMDPI-
dc.relation.ispartofJournal of Clinical Medicine-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectCOVID-19-
dc.subjectepidemiology-
dc.subjecthypernatraemia-
dc.subjectoutcomes-
dc.subjectsodium-
dc.titleEpidemiology and Outcomes of Hypernatraemia in Patients with COVID-19-A Territory-Wide Study in Hong Kong-
dc.typeArticle-
dc.identifier.doi10.3390/jcm12031042-
dc.identifier.scopuseid_2-s2.0-85147805762-
dc.identifier.volume12-
dc.identifier.issue3-
dc.identifier.eissn2077-0383-
dc.identifier.isiWOS:000930151000001-
dc.identifier.issnl2077-0383-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats