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

Abstract

AbstractObjectiveCoronavirus 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.MethodsWe 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.ResultsFemales 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).InterpretationThese 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.Key PointsQuestionDo 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?FindingsFemales 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.MeaningSodium 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.