The association between dysnatraemia during hospitalisation and post COVID-19 mental fatigue

Journal of clinical medicine(2022)

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摘要
Objective Coronavirus disease 2019 (COVID-19) may induce short- and long-term cognitive failures after recovery, but the underlying risk factors are still a matter of debate. Identifying patients at the highest risk is now a research priority to prevent persistent symptoms after recovery. In this study, we investigated whether: (i) the odds of experiencing persistent cognitive failures may differ based on the patients’ disease course severity and sex; (ii) the patients’ electrolytic profile at the acute stage may represent a risk factor for persistent cognitive failures. Methods We analysed data from 204 patients suffering from COVID-19 and hospitalised during the first pandemic wave. According to the 7-point WHO-OS Scale, their disease course was classified as severe (if the patient needed ventilation) or mild (if they did not). We investigated the presence of persistent cognitive failures using a modified version of the Cognitive Failures Questionnaire, collected after hospital discharge, while electrolyte profiles were collected during hospitalisation. We explored our hypotheses via logistic regression models. Results Females who suffered from mild COVID-19 were more likely to report mental fatigue than those with severe COVID-19 ( β = 0.29, 95%CI [0.06; 0.53], p = 0.01). Furthermore, they present a statistically significant risk effect of Na+ alteration at the acute phase on the odds of presenting persistent mental fatigue ( β = 0.37, 95%CI [0.09; 0.64], p = 0.01). Interpretation These findings have important implications for the clinical management of COVID-19 hospitalised patients. Attention should be paid to potential electrolyte imbalances, mainly in females suffering from mild COVID-19. Question Do disease severity and sex predict the risk of persistent cognitive failures in COVID-19 hospitalised survivors? Does electrolytic imbalance at the acute phase represent a risk factor for persistent cognitive failures after recovery? Findings Females who suffered from mild compared to severe COVID-19 had a higher risk of presenting persistent mental fatigue. In this group, dysnatraemia at the acute stage represented a significant risk factor on the odds of showing such a persistent cognitive failure after recovery. Meaning Sodium levels must be monitored and balanced during hospitalisation of females affected by mild COVID-19 to prevent mental fatigue among the possible short- and long-term effects. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Ethical Committee Comitato Etico Area 3 Milano gave ethical approval for this work (N92-15032020 and N408-21072020). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors
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关键词
mental fatigue, long COVID-19, dysnatraemia, electrolyte imbalance
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