The Role of Plasma Osmolarity in the Mortality of Patients with Covid-19
DOI:
https://doi.org/10.21776/ub.jkb.2024.033.02.12Keywords:
Covid-19, mortality, osmolarity, outcomeAbstract
Covid-19 (Coronavirus disease 2019) is a new infectious disease that attacks the respiratory tract and is caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), causing multiorgan failure, often requiring temporary support such as the use of a ventilator or hemodialysis equipment. This condition is related to an imbalance in fluid distribution associated with changes in osmolarity or hyperosmolarity. This research aims to explain the role of plasma osmolarity in Covid-19 patients at dr. Saiful Anwar Hospital, Malang, in patient outcomes, especially death outcomes. The sample for this study was 205 medical records of Covid-19 patients, recorded from September 2021 to May 2022. This study used a retrospective cohort design to describe plasma osmolarity in Covid-19 patients and the outcome of hospitalized patients. There were 205 patient data obtained, with 85 patients dying aged <65 years. Sixty-eight patients of Covid-19 with comorbidities (DM, HT, AKI, CKD, combination) died. There was no difference in plasma osmolarity for living and deceased patients. Repeated plasma osmolarity (retest) had a good degree of accuracy in predicting the outcome of Covid-19 patients, where sensitivity was 71.3% and specificity was 73.4% at a cut-off value of 277.32mOsm/L. The repeat plasma osmolarity value of ≥277.32 had a PPV value of 75%, while plasma osmolarity <277.32 had an NPV value of 69.3%. The OR value was 6.77, meaning that Covid-19 patients with repeated plasma osmolarity levels ≥277.32 would have 6.77 times the risk of mortality compared to Covid-19 patients with repeated plasma osmolarity levels <277.32.
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Burhan E, Agus Dwi Susanto AE, Isbaniah F, et al. Pedoman Tatalaksana Covid-19 Edisi 3. Jakarta; PDPI, PERKI, PAPDI, PERDATIN, IDAI: 2020; p. 36–37.
Alqahtani JS, Oyelade T, Aldhahir AM, et al. Prevalence, Severity and Mortality Associated with COPD and Smoking in Patients with Covid-19: A Rapid Systematic Review and Meta-Analysis. PLoS One. 2020; 15(5): 1-13.
Huang C, Wang Y, Li X, et al. Clinical Features of Patients Infected with 2019 Novel Coronavirus in Wuhan, China. Lancet. 2020; 395(10223): 497–506.
Zhou F, Yu T, Du R, et al. Clinical Course and Risk Factors for Mortality of Adult Inpatients with Covid-19 in Wuhan, China: A Retrospective Cohort Study. Lancet. 2020; 395(10229): 1054–1062.
Shen Y, Cheng X, Ying M, Chang HT, and Zhang W. Association between Serum Osmolarity and Mortality in Patients Who are Critically Ill: A Retrospective Cohort Study. BMJ Open. 2017; 7(5): e015729.
Gou L, Xiang M, Ran X, et al. Hyperosmolarity Deserves More Attention in Critically Ill Covid-19 Patients with Diabetes: A Cohort-Based Study. Diabetes, Metabolic Syndrome Obesity: Targets and Therapy. 2021; 14: 47–58.
Wannamethee SG, Shaper AG, Lennon L, Papacosta O, and Whincup P. Mild Hyponatremia, Hypernatremia and Incident Cardiovascular Disease and Mortality in Older Men: A Population-Based Cohort Study. Nutrition, Metabolism, and Cardiovascular Diseases. 2016; 26(1): 12–19.
Xie J, Cui K, Hao H, et al. Acute Hyperglycemia Suppresses Left Ventricular Diastolic Function and Inhibits Autophagic Flux in Mice Under Prohypertrophic Stimulation. Cardiovascular Diabetology. 2016; 15(1): 1-13.
Corona G, Giuliani C, Parenti G, et al. Moderate Hyponatremia is Associated with Increased Risk of Mortality: Evidence from a Meta-Analysis. PLoS One. 2013; 8(12): 1-11.
Liu Q, Chen H, Li J, et al. Fasting Blood Glucose Predicts the Occurrence of Critical Illness in Covid-19 Patients: A Multicenter Retrospective Cohort Study. The Journal of Infection. 2020; 81(3): 20–23.
Gennari FJ. Current Concepts. Serum Osmolality. Uses and Limitations. The New England Journal of Medicine. 1984; 310(2): 102–105.
Rohla M, Freynhofer MK, Tentzeris I, et al. Plasma Osmolality Predicts Clinical Outcome in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention. European Heart Journal Acute Cardiovascular Care. 2014; 3(1): 84–92.
Nag C, Das K, Ghosh M, and Khandakar MR. Plasma Osmolality in Acute Spontanious Intra-Cerebral Hemorrhage: does it Influence Hematoma Volume and Clinical Outcome? Journal of Research in Medical Sciences. 2012; 17(6): 548–551.
Bhalla A, Sankaralingam S, Dundas R, Swaminathan R, Wolfe CDA, and Rudd AG. Influence of Raised Plasma Osmolality on Clinical Outcome after Acute Stroke. Stroke. 2000; 31(9): 2043–2048.
Chapron A, Shen DD, Kestenbaum BR, Robinson-Cohen C, Himmelfarb J, and Yeung CK. Does Secretory Clearance Follow Glomerular Filtration Rate in Chronic Kidney Diseases? Reconsidering the Intact Nephron Hypothesis. Clinical and Translational Science. 2017; 10(5): 395–403.
Osler T, Glance LG, and Hosmer DW. Complication-Associated Mortality Following Trauma: A Population-Based Observational Study. Archives of Surgery. 2012; 147(2): 152–158.
Kruljac I, Ćaćić M, Ćaćić P, et al. The Impact of Hyperosmolarity on Long-Term Outcome in Patients Presenting with Severe Hyperglycemic Crisis: A Population Based Study. Experimental and Clinical Endocrinology & Diabetes. 2018; 126(9): 564–569.
Bellan M, Patti G, Hayden E, et al. Fatality Rate and Predictors of Mortality in an Italian Cohort of Hospitalized Covid-19 Patients. Scientific Reports. 2020; 10(1): 1-10.
Yang W, Cao Q, Qin L, et al. Clinical Characteristics and Imaging Manifestations of the 2019 Novel Coronavirus Disease (Covid-19): A Multi-Center Study in Wenzhou City, Zhejiang, China. The Journal of Infection. 2020; 80(4): 388–393.
Peng D, Gao Y, Zhou Z, Wang H, and Tang A. Early Risk Factors for Severe Covid-19 in Adults with Hypertension. Cardiology and Cardiovascular Medicine. 2021; 5(6): 726–738.
Mazori AY, Bass IR, Chan L, et al. Hyperglycemia is Associated with Increased Mortality in Critically Ill Patients with COVID-19. Endocrine Practice. 2021; 27(2): 95-100.
Petrovic V, Radenkovic D, Radenkovic G, Djordjevic V, and Banach M. Pathophysiology of Cardiovascular Complications in COVID-19. Frontiers in Physiology. 2021; 11: 1-11.
Ramesh J, Rajesh M, Varghese J, and Reddy SLS. Calculated Plasma Osmolality at Hospital Admission Correlates Well with eGFR and D-Dimer, a Simple Outcome Predictor and Guiding Tool for Management of Severe Covid-19 Patients. Diabetes & Metabolic Syndrome: Clinical Research and Reviews. 2021; 15(5): 1-7
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