1. Elevated Serum Urea-to-Creatinine Ratio and In-Hospital Death in Patients with Hyponatremia Hospitalized for COVID-19
- Author
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Regolisti, G, Rebora, P, Occhino, G, Lieti, G, Molon, G, Maloberti, A, Algeri, M, Giannattasio, C, Valsecchi, M, Genovesi, S, Regolisti, Giuseppe, Rebora, Paola, Occhino, Giuseppe, Lieti, Giulia, Molon, Giulio, Maloberti, Alessandro, Algeri, Michela, Giannattasio, Cristina, Valsecchi, Maria Grazia, Genovesi, Simonetta, Regolisti, G, Rebora, P, Occhino, G, Lieti, G, Molon, G, Maloberti, A, Algeri, M, Giannattasio, C, Valsecchi, M, Genovesi, S, Regolisti, Giuseppe, Rebora, Paola, Occhino, Giuseppe, Lieti, Giulia, Molon, Giulio, Maloberti, Alessandro, Algeri, Michela, Giannattasio, Cristina, Valsecchi, Maria Grazia, and Genovesi, Simonetta
- Abstract
Hyponatremia is associated with adverse outcomes in hospitalized patients. An elevated value of the serum urea-to-creatinine ratio (UCR) has been proposed as a proxy of hypovolemia. The aim of this study was to investigate the relationship between the UCR and in-hospital death in patients hospitalized with COVID-19 and hyponatremia. We studied 258 patients admitted for COVID-19 between January 2020 and May 2021 with serum sodium at < 135 mmol/L. The primary end-point was all-cause mortality. A 5-unit increase in the serum UCR during hospital stays was associated with an 8% increase in the hazard of all-cause death (HR = 1.08, 95% CI: 1.03–1.14, p = 0.001) after adjusting for potential confounders. In patients with a UCR > 40 at baseline, a > 10 mmol/L increase in serum sodium values within the first week of hospitalization was associated with higher odds of in-hospital death (OR = 2.93, 95% CI: 1.03–8.36, p = 0.044) compared to patients who experienced a < 10 mmol/L change. This was not observed in patients with a UCR < 40. Hypovolemia developing during hospital stays in COVID-19 patients with hyponatremia detected at hospital admission bears an adverse prognostic impact. Moreover, in hypovolemic patients, a > 10 mmol/L increase in serum sodium within the first week of hospital stays may further worsen the in-hospital prognosis.
- Published
- 2023