This review examines the prevalence, aetiology, pathophysiology, prognostic value, and investigation of dysnatraemia in hospitalised COVID-19 patients, taking into account all relevant studies published in PubMed and Cochrane Library studies until March 2021. Hyponatraemia is commonly observed in patients with bacterial pneumonia and is an independent predictor for excess mortality and morbidity. However, it remains unknown whether this association applies to coronavirus disease-2019 (COVID-19). Several studies reported a 20-35% prevalence for hyponatraemia and 2-5% for hypernatraemia in patients admitted with COVID-19. In addition, hyponatraemia on admission was a risk factor for progression to severe disease, being associated with an increased likelihood for the need for invasive mechanical ventilation, with an odds ratio (OR) of 1.83-3.30. Hyponatraemia seems to be an independent risk factor for mortality, with an OR of 1.40-1.50 compared to normonatraemia, while hypernatraemia is related to even worse outcomes than hyponatraemia. Furthermore, preliminary data show an inverse association between serum sodium and interleukin-6 levels, suggesting that hyponatraemia might be used as a surrogate marker for the risk of a cytokine storm and the need for treatment with interleukin antagonists. In conclusion, dysnatraemia is common and carries a poor prognosis in COVID-19 patients, indicating that it may play a future role in risk stratification and individualising therapy.

中文翻译：

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内分泌疾病的管理：COVID-19 中的钠血症：患病率、预后影响、病理生理学和管理。

本综述考虑到 2021 年 3 月之前发表在 PubMed 和 Cochrane 图书馆研究中的所有相关研究，检查了住院 COVID-19 患者中钠血症的患病率、病因、病理生理学、预后价值和调查。 低钠血症常见于细菌性肺炎患者并且是过高死亡率和发病率的独立预测因子。然而，这种关联是否适用于 2019 年冠状病毒病 (COVID-19) 仍然未知。几项研究报告称，在 COVID-19 入院的患者中，低钠血症的患病率为 20-35%，高钠血症的患病率为 2-5%。此外，入院时低钠血症是进展为严重疾病的危险因素，与需要有创机械通气的可能性增加有关，优势比 (OR) 为 1.83-3.30。低钠血症似乎是死亡的独立危险因素，与正常钠血症相比，OR 为 1.40-1.50，而高钠血症与比低钠血症更差的结果相关。此外，初步数据显示血清钠和白细胞介素 6 水平之间呈负相关，这表明低钠血症可能被用作细胞因子风暴风险和是否需要用白细胞介素拮抗剂治疗的替代标志物。总之，钠血症在 COVID-19 患者中很常见并且预后较差，这表明它可能在未来的风险分层和个体化治疗中发挥作用。初步数据显示血清钠和白细胞介素 6 水平之间呈负相关，表明低钠血症可能被用作细胞因子风暴风险和是否需要用白细胞介素拮抗剂治疗的替代标志物。总之，钠血症在 COVID-19 患者中很常见并且预后较差，表明它可能在未来的风险分层和个体化治疗中发挥作用。初步数据显示血清钠和白细胞介素 6 水平之间呈负相关，表明低钠血症可能被用作细胞因子风暴风险和是否需要用白细胞介素拮抗剂治疗的替代标志物。总之，钠血症在 COVID-19 患者中很常见并且预后较差，这表明它可能在未来的风险分层和个体化治疗中发挥作用。