Impact of Hyponatremia and ADH Secretion in MIS-C and COVID-19: An Integrative Approach of Prognostic and Diagnostic Markers

The COVID-19 pandemic has introduced challenges in pediatric care, especially due to the emergence of Multisystem Inflammatory Syndrome in Children (MIS-C), a severe condition associated with SARS-CoV-2 infection. This study investigated the impact of hyponatremia and antidiuretic hormone (ADH) secr...

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Main Authors: Diana-Andreea Ciortea, Carmen Loredana Petrea (Cliveți), Sorin Ion Berbece, Silvia Fotea, Iolanda Cristina Vivisenco, Gabriela Gurău, Mădălina Nicoleta Matei, Aurel Nechita
Format: Article
Language:English
Published: MDPI AG 2024-10-01
Series:Current Issues in Molecular Biology
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Online Access:https://www.mdpi.com/1467-3045/46/11/698
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author Diana-Andreea Ciortea
Carmen Loredana Petrea (Cliveți)
Sorin Ion Berbece
Silvia Fotea
Iolanda Cristina Vivisenco
Gabriela Gurău
Mădălina Nicoleta Matei
Aurel Nechita
author_facet Diana-Andreea Ciortea
Carmen Loredana Petrea (Cliveți)
Sorin Ion Berbece
Silvia Fotea
Iolanda Cristina Vivisenco
Gabriela Gurău
Mădălina Nicoleta Matei
Aurel Nechita
author_sort Diana-Andreea Ciortea
collection DOAJ
description The COVID-19 pandemic has introduced challenges in pediatric care, especially due to the emergence of Multisystem Inflammatory Syndrome in Children (MIS-C), a severe condition associated with SARS-CoV-2 infection. This study investigated the impact of hyponatremia and antidiuretic hormone (ADH) secretion corelated to clinical outcomes in these patients. We conducted a retrospective cohort study, including 118 pediatric patients, with a detailed sub-cohort analysis of 53 patients for ADH secretion markers. Hyponatremia, defined by age-specific sodium thresholds, was present in 47.22% of MIS-C cases and 28.04% of COVID-19 cases. Ordinal logistic regression analysis revealed that severe hyponatremia significantly increased the likelihood of more severe clinical outcomes (β = 3.514, <i>p</i> < 0.001). A significant correlation was found between hyponatremia and prolonged hospitalization. For ADH secretion, a predictive model using ridge regression was analysed, which demonstrated that serum sodium level, U/P ratio, and hospitalization duration are key predictors of SIADH. This model fit was assessed using the ROC curve with an AUC of 0.96, indicating reliable model performance. Our findings underscore the significant role of hyponatremia on the clinical severity and hospitalization outcome of COVID-19 and MIS-C in pediatric patients.
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spelling doaj-art-f8cd79298ff64e22935b5d45743d107d2024-11-26T17:57:47ZengMDPI AGCurrent Issues in Molecular Biology1467-30371467-30452024-10-014611117491177110.3390/cimb46110698Impact of Hyponatremia and ADH Secretion in MIS-C and COVID-19: An Integrative Approach of Prognostic and Diagnostic MarkersDiana-Andreea Ciortea0Carmen Loredana Petrea (Cliveți)1Sorin Ion Berbece2Silvia Fotea3Iolanda Cristina Vivisenco4Gabriela Gurău5Mădălina Nicoleta Matei6Aurel Nechita7Faculty of Medicine and Pharmacy, University “Dunarea de Jos” of Galati, 800201 Galati, RomaniaFaculty of Medicine and Pharmacy, University “Dunarea de Jos” of Galati, 800201 Galati, RomaniaFaculty of Medicine and Pharmacy, University “Dunarea de Jos” of Galati, 800201 Galati, RomaniaFaculty of Medicine and Pharmacy, University “Dunarea de Jos” of Galati, 800201 Galati, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 030167 Bucharest, RomaniaFaculty of Medicine and Pharmacy, University “Dunarea de Jos” of Galati, 800201 Galati, RomaniaFaculty of Medicine and Pharmacy, University “Dunarea de Jos” of Galati, 800201 Galati, RomaniaFaculty of Medicine and Pharmacy, University “Dunarea de Jos” of Galati, 800201 Galati, RomaniaThe COVID-19 pandemic has introduced challenges in pediatric care, especially due to the emergence of Multisystem Inflammatory Syndrome in Children (MIS-C), a severe condition associated with SARS-CoV-2 infection. This study investigated the impact of hyponatremia and antidiuretic hormone (ADH) secretion corelated to clinical outcomes in these patients. We conducted a retrospective cohort study, including 118 pediatric patients, with a detailed sub-cohort analysis of 53 patients for ADH secretion markers. Hyponatremia, defined by age-specific sodium thresholds, was present in 47.22% of MIS-C cases and 28.04% of COVID-19 cases. Ordinal logistic regression analysis revealed that severe hyponatremia significantly increased the likelihood of more severe clinical outcomes (β = 3.514, <i>p</i> < 0.001). A significant correlation was found between hyponatremia and prolonged hospitalization. For ADH secretion, a predictive model using ridge regression was analysed, which demonstrated that serum sodium level, U/P ratio, and hospitalization duration are key predictors of SIADH. This model fit was assessed using the ROC curve with an AUC of 0.96, indicating reliable model performance. Our findings underscore the significant role of hyponatremia on the clinical severity and hospitalization outcome of COVID-19 and MIS-C in pediatric patients.https://www.mdpi.com/1467-3045/46/11/698hyponatremiaADHCOVID-19MIS-CpolyuriaSIADH
spellingShingle Diana-Andreea Ciortea
Carmen Loredana Petrea (Cliveți)
Sorin Ion Berbece
Silvia Fotea
Iolanda Cristina Vivisenco
Gabriela Gurău
Mădălina Nicoleta Matei
Aurel Nechita
Impact of Hyponatremia and ADH Secretion in MIS-C and COVID-19: An Integrative Approach of Prognostic and Diagnostic Markers
Current Issues in Molecular Biology
hyponatremia
ADH
COVID-19
MIS-C
polyuria
SIADH
title Impact of Hyponatremia and ADH Secretion in MIS-C and COVID-19: An Integrative Approach of Prognostic and Diagnostic Markers
title_full Impact of Hyponatremia and ADH Secretion in MIS-C and COVID-19: An Integrative Approach of Prognostic and Diagnostic Markers
title_fullStr Impact of Hyponatremia and ADH Secretion in MIS-C and COVID-19: An Integrative Approach of Prognostic and Diagnostic Markers
title_full_unstemmed Impact of Hyponatremia and ADH Secretion in MIS-C and COVID-19: An Integrative Approach of Prognostic and Diagnostic Markers
title_short Impact of Hyponatremia and ADH Secretion in MIS-C and COVID-19: An Integrative Approach of Prognostic and Diagnostic Markers
title_sort impact of hyponatremia and adh secretion in mis c and covid 19 an integrative approach of prognostic and diagnostic markers
topic hyponatremia
ADH
COVID-19
MIS-C
polyuria
SIADH
url https://www.mdpi.com/1467-3045/46/11/698
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