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Meta-Analysis
. 2023 Dec;11(12):e1109.
doi: 10.1002/iid3.1109.

Association of hypernatremia with mortality in patients with COVID-19: A systematic review and meta-analysis

Yongzhi Ma  1 , Panjuan Zhang  1 , Ming Hou  1
Affiliations
Meta-Analysis

Association of hypernatremia with mortality in patients with COVID-19: A systematic review and meta-analysis

Yongzhi Ma et al. Immun Inflamm Dis. 2023 Dec.

Abstract

Background: The COVID-19 pandemic worldwide has caused varying degrees of severity of lung damage in patients, with acute respiratory distress and death in severe cases. However, this is not directly caused by the virus itself, but by the production of inflammasome by monocytes in the body, leading to a systemic inflammatory response, which results in a very poor clinical prognosis for patients with COVID-19.

Objective: The purpose of this meta-analysis was to look at the relationship between hypernatremia and mortality in COVID-19 patients.

Methods: We searched the PubMed, Web of Science, Embase, and Cochrane databases for articles published from the inception of the database until August 27, 2022. Three researchers reviewed the literature, retrieved data, and assessed the quality of the literature, respectively. A meta-analysis was performed using State 17 software to assess the value of the effect of hypernatremia on mortality in patients with new coronavirus pneumonia.

Results: A total of nine publications was finally included in this study, including a total of 11,801 patients with COVID-19, including 1278 in the hypernatremia group and 10,523 in the normonatremia group. Meta-analysis showed that hypernatremia was associated with mortality in patients with COVID-19 [OR = 4.15, 95% CI (2.95-5.84), p = .002, I² = 66.7%] with a sensitivity of 0.36 [0.26, 0.48] and a specificity of 0.88 [0.83, 0.91]. The posterior probability of mortality was 42% in patients with COVID-19 hypernatremia and 15% in patients who did not have COVID-19 hypernatremia.

Conclusion: According to available data, hypernatremia is associated with death in patients with COVID-19.

Keywords: COVID-19; hypernatremia; meta-analysis; mortality; sodium.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Screening flowchart.
Figure 2
Figure 2
Hypernatremia and mortality.
Figure 3
Figure 3
(A) SROC curve. (B) Fagan's nomogram.
Figure 4
Figure 4
Galbraith plot.
Figure 5
Figure 5
Subgroup analysis (A) Sample size >200 (B) Retrospective study.
Figure 6
Figure 6
Hypernatremia and ICU admission.
See this image and copyright information in PMC

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