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Abstract: PO0169

Serum Sodium and Patient Symptoms in COVID-19 Hospitalizations

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Yen, Timothy E., Brigham and Women's Hospital, Boston, Massachusetts, United States
  • Kim, Andy, Brigham and Women's Hospital, Boston, Massachusetts, United States
  • Rutherford, Henry, Brigham and Women's Hospital, Boston, Massachusetts, United States
  • Ratnaparkhi, Saee, Brigham and Women's Hospital, Boston, Massachusetts, United States
  • Woolley, Ann E., Brigham and Women's Hospital, Boston, Massachusetts, United States
  • McCausland, Finnian R., Brigham and Women's Hospital, Boston, Massachusetts, United States
Background

Disorders of serum sodium (SNa) are common in hospitalized patients with COVID-19 and associated with longer length of stay and inpatient mortality. However, the association of SNa with patient-reported outcomes is not clear.

Methods

The Brigham and Women’s Hospital COVID-19 Registry is a prospective cohort study of consecutive, adult patients admitted with confirmed SARS-CoV-2 infection (n=809). We examined the association of SNa (continuous and tertiles) at admission with: 1) patient symptoms obtained from detailed chart review; and 2) in-hospital mortality using unadjusted and adjusted logistic regression models. Covariates included demographic data and comorbidities. Only index admissions were considered.

Results

Mean age was 60 years, 48% were male, and 35% had diabetes. The most frequent symptoms were cough (64%), fever (60%) and shortness of breath (46%). In adjusted models, higher SNa (per mmol/L) was associated with lower odds of GI symptoms (OR 0.96; 95%CI 0.93-0.99), higher odds of confusion (OR 1.08; 95%CI 1.40-1.13) and higher odds of in-hospital mortality (OR 1.06; 95%CI 1.02-1.11). Compared with the lowest tertile, the highest tertile of SNa was associated with a lower odds of GI symptoms and anosmia/ageusia, and higher odds of confusion and in-hospital mortality (Table 1).

Conclusion

In this prospective cohort study of hospitalized patients with COVID-19, hypernatremia is associated with higher odds of confusion and in-hospital mortality, but lower risk of GI symptoms and anosmia. The presence of dysnatremia may help identify higher-risk patients with COVID-19 and prompt ascertainment of patient symptoms, both of which may improve patient-centered approaches to care.