JCEM:血钠异常是COVID-19住院患者发病率和死亡率的预测指标

2021-02-25 MedSci原创 MedSci原创

住院期间血钠异常是COVID-19患者预后不良的危险因素,高钠血症和低钠血症分别与更大的死亡和呼吸衰竭风险相关。血钠水平可用于COVID-19患者的危险分层。

血钠异常是细菌性肺炎患者死亡率的独立预测指标。目前,缺乏新冠肺炎COVID-19)患者血钠异常的发生率和预后影响的数据。

近日,内分泌和代谢性疾病领域权威杂志Journal of Clinical Endocrinology & Metabolism上发表了一篇研究文章,这项回顾性纵向队列研究纳入了所有在伦敦两家医院就诊的COVID-19成年患者。研究人员评估了在几个时间点的血钠异常(血清钠<135或>145 mmol/L,低钠血症和高钠血症)与住院患者死亡率、需要高级通气支持和急性肾损伤(AKI)之间的相关性。

该研究纳入了488位患者(中位年龄为68岁)。在就诊时,24.6%的患者有低钠血症,主要是由于血容量不足,而5.3%的患者伴有高钠血症。与正常人相比,入院后两天内发生的高钠血症和住院期间任何时间点暴露于高钠血症,死亡风险分别增加2.34倍(95%CI为1.08-5.05,p=0.0014)和3.05倍(95%CI为1.69-5.49,p<0.0001)。入院时低钠血症与需要通气支持的可能性增加了2.18倍相关(95%CI为1.34-3.45,p=0.0011)。除低血容量性低钠血症亚组外,低钠血症不是院内死亡的危险因素。血钠水平与AKI风险和住院时间长短无关。

由此可见,住院期间血钠异常是COVID-19患者预后不良的危险因素,高钠血症和低钠血症分别与更大的死亡和呼吸衰竭风险相关。血钠水平可用于COVID-19患者的危险分层。

原始出处:

Ploutarchos Tzoulis.et al.Dysnatremia is a predictor for morbidity and mortality in hospitalized patients with COVID-19.JCEM.2021.https://doi.org/10.1210/clinem/dgab107

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    2021-07-19 hmwwww
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    2021-06-24 achengzhao
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    2021-10-09 smallant2015
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