Hyponatremia and SARS-CoV-2 infection: A narrative review

Abstract

A novel rapid spreading and changing virus called SARS-CoV-2 appeared in Wuhan city in December 2019. It was announced by the World Health Organization (WHO) as a pandemic disease in March 2020. It commonly presents with respiratory symptoms; however, it may be asymptomatic. Electrolyte abnormalities are not uncommon features of SARS-CoV-2 infection. Hyponatremia is one of these electrolyte disturbances among SARS-CoV-2 patients, and it may produce symptoms such as weakness and seizure as the initial presenting symptoms. The underlying mechanism(s) of hyponatremia due to SARS-CoV-2 infection is (are) not established.The aim of this review is to evaluate the possible mechanism of hyponatremia in patients with COVID-19. Understanding and categorizing the hyponatremia in these patients will lead to better treatment and correction of the hyponatremia.A review of the literature between December 2019 and March 2022 was conducted searching for the possible reported mechanism(s) of hyponatremia in SARS-CoV-2.Although SIADH is the commonly reported cause of hyponatremia in SARS-CoV-2 infection, other causes such as diarrhea, vomiting, and kidney salt loss must be considered before SIADH.

Acute Kidney Injury and Chronic Kidney Disease and Their Impacts on Prognosis among Patients with Severe COVID-19 Pneumonia: An Expert Center Case–Cohort Study

“…Noteworthy plasma sodium alterations are frequently observed in COVID-19. Early papers reported both hypo- and hypernatremia, whereas some individuals had both disturbances during one hospital stay [ 28 ]. The first clinical explanation for hyponatremia among COVID-19 patients was the development of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) [ 28 ].…”

“…Early papers reported both hypo- and hypernatremia, whereas some individuals had both disturbances during one hospital stay [ 28 ]. The first clinical explanation for hyponatremia among COVID-19 patients was the development of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) [ 28 ]. Later explanations for the cause of hyponatremia included increased serum interleukin-6 levels, centrally induced hypocortisolism, vomiting, diarrhea, intestine cell damage, and kidney involvement with proximal tubulopathy [ 28 ].…”

“…The first clinical explanation for hyponatremia among COVID-19 patients was the development of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) [ 28 ]. Later explanations for the cause of hyponatremia included increased serum interleukin-6 levels, centrally induced hypocortisolism, vomiting, diarrhea, intestine cell damage, and kidney involvement with proximal tubulopathy [ 28 ]. Interestingly, hypernatremia (6.8%) was observed much less frequently than hyponatremia (26.5%) but has been correlated with a longer hospital stay and a greater need for ICU and mechanical ventilation [ 29 ].…”

A Comparative Analysis of Adult Hydronephrosis at a Tertiary Care Hospital: Uncovering Uncommon Etiologies

“…Hydronephrosis, characterized by the dilation of the kidney due to urine build-up, represents a significant medical concern, particularly in adult populations within tertiary care hospitals (1). The complexity inherent in adult cases of hydronephrosis, often attributed to a diverse range of aetiologies and comorbid conditions, necessitates a detailed understanding for effective management and treatment strategies (2,3).…”

SARS‑CoV‑2 and Seizure: An Insight Into the Pathophysiology

“…According to Habas et al, electrolyte abnormalities are not uncommon among SARS-CoV-2 patients, and hyponatremia is considered one of these electrolyte disorders. The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most prevalent cause of hyponatremia and can initially manifest as seizures ( 22 , 23 ).…”