Yıl: 2023 Cilt: 65 Sayı: 4 Sayfa Aralığı: 572 - 582 Metin Dili: İngilizce DOI: 10.24953/turkjped.2022.1027 İndeks Tarihi: 13-09-2023

The prevalence and prognostic effect of hyponatremia in children with COVID-19 pneumonia: a retrospective study

Öz:
Background. The aim of the study was to examine the effect of hyponatremia at admission as a negative prognostic factor in children hospitalized with COVID-19 pneumonia. Methods. The data of patients aged 1 month-18 years, who were followed with the diagnosis of pneumonia at Çanakkale Onsekiz Mart University Hospital, Department of Pediatrics, between January 2018 and May 2021 were examined, retrospectively. Patients (n=661) were divided into two main groups; COVID-19 pneumonia (n=158) and the other pneumonias [other viral pneumonia (n=161) and pneumonia of unknown etiology (n=342)]. Results. Six hundred and twenty-three patients with a median (Q1-Q3) age of 4 (1.5-8) years, 59.4% of whom were male were included in the study. The overall prevalence of hyponatremia at admission was 11.2% and was lower in those with COVID-19 pneumonia than in those with other viral pneumonia (6.4% vs. 15.2%, p=0.013). When evaluated irrespective of their COVID-19 status, hyponatremic patients had a higher supplemental oxygen requirement (OR 2.5 [1.4-4.3], p<0.001), higher need for intensive care unit (ICU) admission (OR 3.7 [1.3–10.2], p=0.009) and longer duration of hospitalization (p=0.016) than the normonatremic patients. In patients with COVID-19 pneumonia, being hyponatremic had no effect on supplemental oxygen requirements or the duration of hospitalization. When hyponatremic patients were evaluated, the supplemental oxygen requirements and duration of hospitalization of those with COVID-19 pneumonia were similar to the other pneumonias (p>0.05 for all comparisons). However, normonatremic COVID-19 pneumonias had higher supplemental oxygen requirements than other viral pneumonias and pneumonia of unknown etiology (OR 4.7 [2.2–10.3], p<0.001; OR 1.6 [1 –2.7], p=0.043, respectively). Conclusion. This study found that hyponatremia at admission is rarer in children with COVID-19 pneumonia than other viral pneumonias and has no effect on supplemental oxygen requirements or the duration of hospitalization.
Anahtar Kelime: child hyponatremia COVID-19 prevalence prognosis.

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Sakellaropoulou A, Hatzistilianou M, Eboriadou M, Athanasiadou-Piperopoulou F. Hyponatraemia in cases of children with pneumonia. Arch Med Sci 2010; 6: 578-583. https://doi.org/10.5114/ aoms.2010.14471
  • 2. Tzoulis P. Prevalence, prognostic value, pathophysiology, and management of hyponatraemia in children and adolescents with COVID-19. Acta Biomed 2021; 92: e2021474. https:// doi.org/10.23750/abm.v92i5.12330
  • 3. Hasegawa K, Stevenson MD, Mansbach JM, et al. Association between hyponatremia and higher bronchiolitis severity among children in the ICU with bronchiolitis. Hosp Pediatr 2015; 5: 385-389. https://doi.org/10.1542/hpeds.2015-0022
  • 4. World Health Organization (WHO). WHO Coronavirus Disease (COVID-19) dashboard. Available at: https://covid19.who.int/ (Accessed on August 07, 2022).
  • 5. Fernandez Martinez A, Barajas Galindo D, Ruiz Sanchez J. Management of hyponatraemia and hypernatraemia during the Covid-19 pandemic: a consensus statement of the Spanish Society for Endocrinology (Acqua Neuroendocrinology Group). Rev Endocr Metab Disord 2021; 22: 317-324. https://doi.org/10.1007/s11154-021-09627-3
  • 6. Pourfridoni M, Abbasnia SM, Shafaei F, Razaviyan J, Heidari-Soureshjani R. Fluid and electrolyte disturbances in COVID-19 and their complications. Biomed Res Int 2021; 2021: 6667047. https://doi. org/10.1155/2021/6667047
  • 7. Berni A, Malandrino D, Corona G, et al. Serum sodium alterations in SARS CoV-2 (COVID-19) infection: impact on patient outcome. Eur J Endocrinol 2021; 185: 137-144. https://doi.org/10.1530/EJE-20-1447
  • 8. Machiraju PK, Alex NM, Safinaaz, Vadamalai V. Hyponatremia in Coronavirus Disease-19 patients: a retrospective analysis. Can J Kidney Health Dis 2021; 8: 20543581211067069. https://doi. org/10.1177/20543581211067069
  • 9. Ayus JC, Negri AL, Moritz ML, et al. Hyponatremia, inflammation at admission, and mortality in hospitalized COVID-19 patients: a prospective cohort study. Front Med (Lausanne) 2021; 8: 748364. https://doi.org/10.3389/fmed.2021.748364
  • 10. Mills T, Trivedi A, Tremoulet AH, Hershey D, Burns JC. Hyponatremia in patients with multisystem inflammatory syndrome in children. Pediatr Infect Dis J 2021; 40: e344-e346. https://doi.org/10.1097/ INF.0000000000003219
  • 11. Sorkhi H, Esmaeili Dooki M, Nikpour M, et al. COVID-19 and renal involvement in children: a retrospective study. Caspian J Intern Med 2022; 13: 193-198. https://doi.org/10.22088/cjim.13.0.193
  • 12. De Carvalho H, Letellier T, Karakachoff M, et al. Hyponatremia is associated with poor outcome in COVID-19. J Nephrol 2021; 34: 991-998. https://doi. org/10.1007/s40620-021-01036-8
  • 13. Frontera JA, Valdes E, Huang J, et al. Prevalence and impact of hyponatremia in patients with Coronavirus Disease 2019 in New York City. Crit Care Med 2020; 48: e1211-e1217. https://doi. org/10.1097/CCM.0000000000004605
  • 14. Atila C, Sailer CO, Bassetti S, et al. Prevalence and outcome of dysnatremia in patients with COVID-19 compared to controls. Eur J Endocrinol 2021; 184: 409-418. https://doi.org/10.1530/EJE-20-1374
  • 15. Das M, Narain B. Hyponatremia in children with severe pneumonia and its effect on overall outcome. Int J Contemp Pediatr 2019; 6: 2516-2521. https://doi. org/10.18203/2349-3291.ijcp20194727
  • 16. Kaneko K, Kaneko K. Hyponatremia in children with respiratory tract infection. Pediatr Nephrol 2009; 24: 1595-1598. https://doi.org/10.1007/s00467- 009-1139-4
  • 17. Mazzoni MB, Milani GP, Bernardi S, et al. Hyponatremia in infants with community-acquired infections on hospital admission. PLoS One 2019; 14: e0219299. https://doi.org/10.1371/journal. pone.0219299
  • 18. Jha CB, Tamrakar A. Assessment of hyponatremia in pneumonia in children. Birat Journal of Health Sciences 2018; 7: 542-547. https://doi.org/10.3126/ bjhs.v3i3.22172
  • 19. Park SW, Shin SM, Jeong M, et al. Hyponatremia in children with respiratory infections: a cross-sectional analysis of a cohort of 3938 patients. Sci Rep 2018; 8: 16494. https://doi.org/10.1038/s41598-018-34703-1
  • 20. Li K, Li L, Wang X, et al. Comparative analysis of clinical features of SARS-CoV-2 and adenovirus infection among children. Virol J 2020; 17: 193. https://doi.org/10.1186/s12985-020-01461-4
  • 21. Yoshida M, Worlock KB, Huang N, et al. Local and systemic responses to SARS-CoV-2 infection in children and adults. Nature 2022; 602: 321-327. https://doi.org/10.1038/s41586-021-04345-x
  • 22. Dean P, Florin TA. Factors associated with pneumonia severity in children: a systematic review. J Pediatric Infect Dis Soc 2018; 7: 323-334. https://doi. org/10.1093/jpids/piy046
  • 23. Hu W, Lv X, Li C, et al. Disorders of sodium balance and its clinical implications in COVID-19 patients: a multicenter retrospective study. Intern Emerg Med 2021; 16: 853-862. https://doi.org/10.1007/s11739-020- 02515-9
  • 24. Lippi G, South AM, Henry BM. Electrolyte imbalances in patients with severe coronavirus disease 2019 (COVID-19). Ann Clin Biochem 2020; 57: 262-265. https://doi.org/10.1177/0004563220922255
  • 25. Asseri AA, Shati AA, Al-Qahtani SM, et al. Distinctive clinical and laboratory features of COVID-19 and H1N1 influenza infections among hospitalized pediatric patients. World J Pediatr 2021; 17: 272-279. https://doi.org/10.1007/s12519-021-00432-1
  • 26. Pucarelli-Lebreiro G, Venceslau MT, Cordeiro CC, et al. Clinical manifestations and complications of children with COVID-19 compared to other respiratory viral infections: a cohort inpatient study from Rio de Janeiro, Brazil. Front Pediatr 2022; 10: 934648. https://doi.org/10.3389/fped.2022.934648
  • 27. Tasar S, Karadag-Oncel E, Yilmaz-Ciftdogan D, et al. Influenza is more severe than our newest enemy (COVID-19) in hospitalized children: Experience from a tertiary center. J Med Virol 2022; 94: 4107- 4114. https://doi.org/10.1002/jmv.27817
  • 28. Liang F, Wang X, Shao J, et al. Comparison of clinical features on admission between coronavirus disease 2019 and influenza a among children: a retrospective study in China. BMC Infect Dis 2021; 21: 365. https:// doi.org/10.1186/s12879-021-06037-3
  • 29. Liu M, Han Y, Sun J, et al. Comparison of the epidemiological and clinical characteristics of hospitalized children with pneumonia caused by SARS-CoV-2, influenza A, and human adenoviruses: a case-control study. Clin Pediatr (Phila) 2022; 61: 150-158. https://doi.org/10.1177/00099228211058601
APA Çelik T, doğan d, PARLAK Ç (2023). The prevalence and prognostic effect of hyponatremia in children with COVID-19 pneumonia: a retrospective study. , 572 - 582. 10.24953/turkjped.2022.1027
Chicago Çelik Taylan,doğan durmuş,PARLAK Çağrı Furkan The prevalence and prognostic effect of hyponatremia in children with COVID-19 pneumonia: a retrospective study. (2023): 572 - 582. 10.24953/turkjped.2022.1027
MLA Çelik Taylan,doğan durmuş,PARLAK Çağrı Furkan The prevalence and prognostic effect of hyponatremia in children with COVID-19 pneumonia: a retrospective study. , 2023, ss.572 - 582. 10.24953/turkjped.2022.1027
AMA Çelik T,doğan d,PARLAK Ç The prevalence and prognostic effect of hyponatremia in children with COVID-19 pneumonia: a retrospective study. . 2023; 572 - 582. 10.24953/turkjped.2022.1027
Vancouver Çelik T,doğan d,PARLAK Ç The prevalence and prognostic effect of hyponatremia in children with COVID-19 pneumonia: a retrospective study. . 2023; 572 - 582. 10.24953/turkjped.2022.1027
IEEE Çelik T,doğan d,PARLAK Ç "The prevalence and prognostic effect of hyponatremia in children with COVID-19 pneumonia: a retrospective study." , ss.572 - 582, 2023. 10.24953/turkjped.2022.1027
ISNAD Çelik, Taylan vd. "The prevalence and prognostic effect of hyponatremia in children with COVID-19 pneumonia: a retrospective study". (2023), 572-582. https://doi.org/10.24953/turkjped.2022.1027
APA Çelik T, doğan d, PARLAK Ç (2023). The prevalence and prognostic effect of hyponatremia in children with COVID-19 pneumonia: a retrospective study. Turkish Journal of Pediatrics, 65(4), 572 - 582. 10.24953/turkjped.2022.1027
Chicago Çelik Taylan,doğan durmuş,PARLAK Çağrı Furkan The prevalence and prognostic effect of hyponatremia in children with COVID-19 pneumonia: a retrospective study. Turkish Journal of Pediatrics 65, no.4 (2023): 572 - 582. 10.24953/turkjped.2022.1027
MLA Çelik Taylan,doğan durmuş,PARLAK Çağrı Furkan The prevalence and prognostic effect of hyponatremia in children with COVID-19 pneumonia: a retrospective study. Turkish Journal of Pediatrics, vol.65, no.4, 2023, ss.572 - 582. 10.24953/turkjped.2022.1027
AMA Çelik T,doğan d,PARLAK Ç The prevalence and prognostic effect of hyponatremia in children with COVID-19 pneumonia: a retrospective study. Turkish Journal of Pediatrics. 2023; 65(4): 572 - 582. 10.24953/turkjped.2022.1027
Vancouver Çelik T,doğan d,PARLAK Ç The prevalence and prognostic effect of hyponatremia in children with COVID-19 pneumonia: a retrospective study. Turkish Journal of Pediatrics. 2023; 65(4): 572 - 582. 10.24953/turkjped.2022.1027
IEEE Çelik T,doğan d,PARLAK Ç "The prevalence and prognostic effect of hyponatremia in children with COVID-19 pneumonia: a retrospective study." Turkish Journal of Pediatrics, 65, ss.572 - 582, 2023. 10.24953/turkjped.2022.1027
ISNAD Çelik, Taylan vd. "The prevalence and prognostic effect of hyponatremia in children with COVID-19 pneumonia: a retrospective study". Turkish Journal of Pediatrics 65/4 (2023), 572-582. https://doi.org/10.24953/turkjped.2022.1027