• Abhigan Babu Shrestha, Unnat Hamal Sapkota, Sajina Shrestha, Manjil Aryal, Swati Chand, Sangharsha Thapa, Faisal Chowdhury, Abdullah Salman, Shumneva Shrestha, Sangam Shah, and Vikash Jaiswal.
• M Abdur Rahim Medical College, Dinajpur, Bangladesh.
• Medicine (Baltimore). 2022 Dec 23; 101 (51): e32535e32535.

BackgroundThis systematic review and meta-analysis aimed to assess the association of hypernatremia with the outcomes of COVID-19 patients.MethodsWe performed a systematic literature search on PubMed, Google Scholar, and Science Direct until October 2021 and found a total of 131 papers. With meticulous screening finally, 17 papers met the inclusion criteria. COVID-19 patients with sodium levels greater than the reference level were the study population and the outcome of interest was the poor outcome; such as mortality, mechanical ventilation, intensive care unit (ICU) admission, and prolonged hospital stay. The pooled estimate was calculated as the odds ratio (OR).ResultsThere were 19,032 patients with hypernatremia in the 17 studies included. An overall random effect meta-analysis showed that hypernatremia was associated with mortality (OR: 3.18 [1.61, 6.28], P < .0001, I2 = 91.99%), prolong hospitalization (OR: 1.97 [1.37, 2.83], P < .001, I2 = 0.00%) and Ventilation (OR: 5.40 [1.89, 15.42], P < .001, I2 = 77.35%), ICU admission (OR: 3.99 [0.89, 17.78], P = .07, I2 = 86.79%). Meta-regression analysis showed the association of age with the ICU outcome of hypernatremia patients. Whereas, other parameters like male, hypertension, chronic kidney disease, and diabetes mellitus did not significantly influence the odds ratio.ConclusionHypernatremia was markedly associated with poor outcomes in patients with COVID-19. Hence, a blood ionogram is warranted and special attention must be given to hypernatremia COVID-19 patients.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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