Prognostic Impact of Dysnatremia in COVID-19 Pneumonia: Risk Stratification of Hospitalized Patients

Background Severe dysnatremia is associated with poor prognosis and worse outcome and therefore needs more attention to unravel its relation with poor prognosis in patients admitted with coronavirus disease 2019 (COVID-19). Aim of our study was to determine varying degree of dysnatremia among hospitalized COVID-19 patients and identify the clinical outcome associated with it. Method This is a retrospective record analysis study done on the hospitalized COVID-19 patients in Guwahati Neurological Research Centre Medical, North Guwahati. For every included patient, his or her medical records were extracted from a standardized electronic medical record collection system and scrutinised anonymously. Results COVID-19 positive participants were divided into four categories like, dysnatremic (serum sodium > 146 or < 134 mmol/L), hypernatremic (> 146 mmol/L), hyponatremic (< 134 mmol/L) and eunatremic (134 ‒ 146 mmol/L). Total 37.9% of the included COVID-19 participants exhibited dysnatremia compared to only 20% of the patients from the control group demonstrating a significant difference ( p  = 0.02). Hypernatremia was significantly high ( p  = 0.01) compared to hyponatremia among COVID-19 positive participants (27.7% vs 12.3%) and also turned out to be relatively severe with significantly high ICU admittance (p < 0.0001) and mortality rate ( p  = 0.01). Magnitude of dysnatremic patients showing aberration in the circulatory level of the other laboratory parameters was significantly high to that of eunatremic group with high fatality rate among hypernatremic. Both hyper and hyponatremic group demonstrated significantly high SOFA score but increased mortality risk, based on CURB 65 score and 2.35 fold increased probability of death was observed in hypernatremic group. Conclusion Dysnatremia, with special mention to hypernatremia, is associated with increased casualty rate, aberrant laboratory parameters and ICU admittance. This highlights the significance of considering dysnatremia as a predictive outcome marker and thus directs a correct path for appropriate management of COVID-19 patients.