(544) The Impact of Sodium Levels on Hospitalization Duration and Mortality in COVID-19 Patients

Introduction: Sodium levels can vary in different patients and can cause sudden deaths in coronavirus disease 2019 (COVID-19). This study aimed to evaluate the effect of sodium levels in COVID-19 patients on mortality, days of hospitalization, and mechanical ventilation.

Methods: A retrospective study of adult patients admitted to our hospital with COVID-19 infection from March 2020 to February 2022 was conducted. The patients were divided into three groups. Group 1 (G1) are those who had hyponatremia ( < 134 mEq/L), group 2 (G2) eunatremia (135 to 145 mEq/L) and group 3 (G3) hypernatremia (>146 mEq/L) during hospitalization. The primary outcomes were mortality, need for mechanical ventilation, and length of stay. Descriptive statistics, Pearson Chi-square and Kruskal-Wallis tests were used. A p ≤ 0.05 was considered statistically significant.

Results: Eight hundred thirty patients were included in the study. Four hundred sixty-eight (56.4%) patients were men. The median age was 55.0 [44-66.0] years. One hundred fifty-eight patients were Caucasians (19.0%), Hispanics 474 (57.1%), African Americans 164 (19.8%), and 34 others (4.1%). There was a statistically significant association between sodium levels, number of survival and length of hospital stay (p < 0.001). A total of 677 (81.6%) patients survived. Twenty-seven (72.1%), 497 (96.1%) and 153 (55.0%) patients survived in hyponatremia, eunatremia and hypernatremia respectively; (p < 0.001). There was a statistically significant association between hospital days 3.0 [2.0-6.0], 6.0 [3.0-9.0] and 12.0 [7.0-19.0] patients respectively, (p < 0.001). Median length of Stay (LOS) was 7.0 days [4.0-12.0]. There was no statistically significant association between sodium levels and need for mechanical ventilation in all three groups: (p= 0.788). In the patients with hyponatremia, 28 (80.0%) patients were not mechanically ventilated. Those who had eunatremia 424 (83.9%) did not require mechanical ventilation. In patients with hypernatremia, 235 (84.51%) were not ventilated.

Conclusions: In this cohort, elevated sodium levels were associated with lower rates of survival, mortality, and length of stay in hospitalized patients with COVID-19.