Assessment of electrolyte abnormalities in older adults with COVID-19 and delirium.

OBJECTIVES

This retrospective cohort study investigated the impact of COVID-19 on altered sodium and potassium in older adults with delirium compared to a non-COVID pneumonia control group.

METHODS

Electronic Medical Records (EMRs) from a university hospital database were reviewed for electrolyte abnormalities and delirium. We identified 319 patients with COVID-19, of which 108 (33.8%) had an episode of delirium during COVID. In a second cohort of 306 older adults with non-COVID pneumonias, we identified 106 (34.6%) with delirium during pneumonia.

RESULTS

Electrolyte disturbances were more commonly present in non-COVID pneumonias versus in those with COVID (p < 0.001). Hypokalemia was more frequent in the non-COVID group (p < 0.006), while hypernatremia was more often identified in the COVID group (p < 0.0321). Delirium in COVID patients was more commonly associated with hypernatremia than with other electrolyte abnormalities.

CONCLUSIONS

Because hypernatremia can be associated with seizures and cerebral hemorrhage, our findings highlight the need for careful monitoring and management of hypernatremia in hospitalized COVID patients, especially in light of its observed association with delirium.