Association between baseline sodium level, fluid therapy and outcomes in patients with coronavirus disease 2019

IF 2.5 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in medical sciences Pub Date : 2026-03-01 Epub Date: 2026-04-02 DOI:10.1016/j.advms.2026.04.001

Maciej Niczewski , Maciej Dyrbuś , Szymon Gawęda , Anna Danel , Mikołaj Rycerski , Aleksandra Oraczewska , Agata Stanek , Jan Duława , Szymon Skoczyński

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Abstract

Purpose

This study aimed to determine a correlation between baseline sodium levels, laboratory test results, and clinical condition as well as the association between sodium level changes during treatment and prognosis of patients with COVID-19.

Materials and methods

Our retrospective analysis included 1673 patients hospitalized due to COVID-19 at the Temporary Hospital in Pyrzowice. The patients were treated in accordance with the hospital's treatment protocol, including standard fluid therapy regimen adjusted to oxygen support. The analysis considered data on comorbidities, laboratory tests results, blood gas analysis and computed tomography. The endpoints were the need for treatment in the intensive care unit, length of hospital stay, in-hospital mortality, and long-term mortality.

Results

Abnormal sodium levels were found in 35.7% (597) of patients. This correlated with comorbidities and abnormal laboratory test results. Baseline sodium imbalance correlated with longer hospitalization and increased in-hospital and long-term mortality rates. Significant sodium level changes (≥6 mmol/L) were observed in 148 patients which correlated with higher in-hospital and long-term mortality rates.

Conclusions

Baseline sodium imbalances and significant sodium level changes during treatment are associated with worse prognosis of COVID-19. According to our best knowledge there are no prospective randomized studies which would compare different fluid strategies in COVID-19 patients. Further prospective studies comparing different fluid therapy strategies and different compositions of fluids should be conducted.

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2019冠状病毒病患者基线钠水平、液体治疗与结局之间的关系

目的：本研究旨在确定基线钠水平、实验室检测结果和临床状况之间的相关性，以及治疗期间钠水平变化与COVID-19患者预后之间的关系。材料与方法：我们回顾性分析了在皮尔佐维采市临时医院因COVID-19住院的1673例患者。患者按照医院的治疗方案进行治疗，包括标准的液体治疗方案调整为氧支持。该分析考虑了合并症、实验室检查结果、血气分析和计算机断层扫描的数据。终点是在重症监护病房治疗的需要、住院时间、住院死亡率和长期死亡率。结果：597例患者中有35.7%出现钠异常。这与合并症和实验室检查结果异常有关。基线钠失衡与住院时间延长、住院和长期死亡率增加相关。148例患者钠水平明显改变（≥6 mmol/L），与较高的住院死亡率和长期死亡率相关。结论：治疗期间基线钠失衡和钠水平显著变化与COVID-19预后不良相关。据我们所知，目前还没有前瞻性随机研究来比较COVID-19患者的不同液体策略。进一步的前瞻性研究比较不同的液体治疗策略和不同成分的液体应进行。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in medical sciences 医学-医学：研究与实验

CiteScore

5.00

自引率

0.00%

发文量

审稿时长

25 days

期刊介绍： Advances in Medical Sciences is an international, peer-reviewed journal that welcomes original research articles and reviews on current advances in life sciences, preclinical and clinical medicine, and related disciplines. The Journal’s primary aim is to make every effort to contribute to progress in medical sciences. The strive is to bridge laboratory and clinical settings with cutting edge research findings and new developments. Advances in Medical Sciences publishes articles which bring novel insights into diagnostic and molecular imaging, offering essential prior knowledge for diagnosis and treatment indispensable in all areas of medical sciences. It also publishes articles on pathological sciences giving foundation knowledge on the overall study of human diseases. Through its publications Advances in Medical Sciences also stresses the importance of pharmaceutical sciences as a rapidly and ever expanding area of research on drug design, development, action and evaluation contributing significantly to a variety of scientific disciplines. The journal welcomes submissions from the following disciplines: General and internal medicine, Cancer research, Genetics, Endocrinology, Gastroenterology, Cardiology and Cardiovascular Medicine, Immunology and Allergy, Pathology and Forensic Medicine, Cell and molecular Biology, Haematology, Biochemistry, Clinical and Experimental Pathology.