Table_1_Prognostic Impact of Hyponatremia and Hypernatremia in COVID-19 Pneumonia. A HOPE-COVID-19 (Health Outcome Predictive Evaluation for COVID-19) Registry Analysis.docx

Dysnatremia is associated with increased mortality in patients with community-acquired pneumonia. SARS-COV2 (Severe-acute-respiratory syndrome caused by Coronavirus-type 2) pneumonia can be fatal. The aim of this study was to ascertain whether admittance dysnatremia is associated with mortality, sepsis, or intensive therapy (IT) in patients hospitalized with SARS-COV2 pneumonia. This is a retrospective study of the HOPE-COVID-19 registry, with data collected from January 1th through April 31th, 2020. We selected all hospitalized adult patients with RT-PCR-confirmed SARS-COV2 pneumonia and a registered admission serum sodium level (SNa). Patients were classified as hyponatremic (SNa <135 mmol/L), eunatremic (SNa 135–145 mmol/L), or hypernatremic (SNa >145 mmol/L). Multivariable analyses were performed to elucidate independent relationships of admission hyponatremia and hypernatremia, with mortality, sepsis, or IT during hospitalization. Four thousand six hundred sixty-four patients were analyzed, median age 66 (52–77), 58% males. Death occurred in 988 (21.2%) patients, sepsis was diagnosed in 551 (12%) and IT in 838 (18.4%). Hyponatremia was present in 957/4,664 (20.5%) patients, and hypernatremia in 174/4,664 (3.7%). Both hyponatremia and hypernatremia were associated with mortality and sepsis. Only hyponatremia was associated with IT. In conclusion, hyponatremia and hypernatremia at admission are factors independently associated with mortality and sepsis in patients hospitalized with SARS-COV2 pneumonia.
Clinical Trial Registrationhttps://clinicaltrials.gov/ct2/show/NCT04334291, NCT04334291.

血钠异常（Dysnatremia）与社区获得性肺炎患者的死亡率升高相关。新型冠状病毒2型（SARS-CoV-2，Severe Acute Respiratory Syndrome Coronavirus 2）所致肺炎具有致死性。本研究旨在明确收治的新型冠状病毒2型肺炎患者入院时的血钠异常是否与其住院期间的死亡率、脓毒症或重症监护治疗（intensive therapy, IT）相关。
本研究为一项基于HOPE-COVID-19登记数据库的回顾性研究，数据收集时段为2020年1月1日至2020年4月31日。我们纳入了所有经逆转录聚合酶链反应（RT-PCR）确诊为新型冠状病毒2型肺炎的住院成年患者，且其入院时血清钠（SNa）水平有完整登记记录。将患者分为低钠血症组（SNa＜135 mmol/L）、血钠正常组（SNa 135~145 mmol/L）及高钠血症组（SNa＞145 mmol/L）。通过多变量分析，阐明入院时低钠血症与高钠血症和患者住院期间死亡率、脓毒症及重症监护治疗之间的独立关联。
本研究共纳入4664例患者进行分析，患者中位年龄为66岁（四分位间距52~77），男性占比58%。其中988例（21.2%）患者死亡，551例（12%）被诊断为脓毒症，838例（18.4%）接受了重症监护治疗。957例（20.5%，957/4664）患者存在低钠血症，174例（3.7%，174/4664）患者存在高钠血症。低钠血症与高钠血症均与死亡率及脓毒症相关；仅低钠血症与重症监护治疗存在关联。
综上，入院时的低钠血症与高钠血症是新型冠状病毒2型肺炎住院患者死亡率及脓毒症的独立相关因素。
临床试验注册：https://clinicaltrials.gov/ct2/show/NCT04334291，注册号NCT04334291。