Hyponatremia in COVID-19 patient using angiotensin type 1 receptor (AT1R) blocker and diuretic: a case report

We examined electrolyte imbalance and blood sugar levels in patients with COVID-19 who had no underlying disease. This cross-sectional study in a clinical center was performed in Kermanshah, west of Iran. All patients who had a record of magnesium (Mg 2+ ), potassium (K + ), sodium (Na+), and fasting blood sugar (FBS) tests in their clinical files at the time of admission to the hospital from April 21 to July 12, and didn't have a history of an underlying disease, were included in the study. Patients were divided into outpatient (as less severe COVID-19) and intensive care units (ICU) (as severe COVID-19). For statistical analysis of collected data, the SPSS software (version 16) was used. Among a total of 134 patients, 58 cases (24 ICU and 34 outpatients) were included in the study. The mean and median age was 56 and 62 years, respectively. From all included, 33 men (57%), 25 women (43%), 52 urban (89.7%), 6 rural (10.3%), 41 alive (70.7%), and 17 died (29.3%) were recorded. From all included patients, 49.1% hyperglycemia, 38% hyponatremia, 7.3% hypokalemia, and 32% hypomagnesemia were observed. Unlike the mean of age and the level of K+, there was a statistically significant difference between the outpatient and ICU groups in terms of Mg 2+ , Na + , and FBS (p < 0.05). Hyperglycemia and electrolyte imbalance in COVID-19 patients is feasible. Therefore, notice to measuring these cases and monitoring the patient can be effective in the treatment process and prevent the serious complications of the disease.

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“…Hyponatraemia has been reported in COVID-19 [ [22] , [23] , [24] ]. In a retrospective study conducted by Zhang et al.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of electrolyte status of sodium, potassium and magnesium, and fasting blood sugar at the initial admission of individuals with COVID-19 without underlying disease in Golestan Hospital, Kermanshah

Sarvazad¹,

Cahngaripour²,

Roozbahani³

et al. 2020

New Microbes and New Infections

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“…Also, hyponatraemia was found in 8% of patients with community-acquired pneumonia, with nearly half of the cases having SIADH [57]. Also, hyponatraemia has been reported in COVID-19 [15,19,31,53,58]. In a retrospective study conducted by Zhang et al [53], the association between hyponatraemia and the severity of COVID-19 was considered.…”

Section: Discussionmentioning

confidence: 99%

Effect of Coronavirus Infection on Fasting Blood Glucose, Kidney Function, and Electrolytes in COVID-19 Patients in the Zawia Region, Western Libya

Azab¹

2021

BTBP

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Background: Coronavirus disease 19 (COVID-19) is a pandemic infectious disease caused by the novel coronavirus. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). It is an aggressive virus that spread worldwide and is a systemic disease involving multiple systems, including respiratory, cardiovascular, gastrointestinal, hematopoietic, neurological, immune, and urinogenital systems. Objectives: The present study aimed to evaluate the alteration in fasting blood glucose, serum urea, creatinine, Na+, K+, and Cl- levels among COVID-19 patients in the Zawia region, Western Libya. Materials and Methods: 416 confirmed COVID-19 patients hospitalized in the Isolation Centre located in Zawia city, Libya. From the 1st May 2020 to the 30th March 2021, were enrolled in this prospective study. Covid-19 patients were defined as positive cases after the detection of SARS-CoV-2 RNA in oro-nasopharyngeal swab samples. Demographic data were extracted from electronic medical records and patient files. Also, 30 healthy individuals without any chronic disease or respiratory symptoms were recruited for the control group. Blood samples were collected via vein puncture for estimating biochemical parameters (fasting blood glucose, serum urea, creatinine, Na+, K+, and Cl- concentrations). The statistical significance of differences between groups was evaluated with the Mann- Whitney (U test). Associations between different parameters were evaluated with the Spearman's test. Results: The results showed that coronavirus infection induced a significant increase in fasting blood glucose, serum urea, and creatinine concentrations. Infections also induced a decrease in serum sodium ion concentration, compared with healthy individuals. Seventy-six percent of corona virus-infected patients had hyperglycemia. Similarly, high levels of serum urea, creatinine, Cl-, Na+, and K+ were found in 40.9%, 39.9%, 27.9%, 8.9% and 6.5% of patients, respectively. Hyponatraemia, hypokalaemia, and hypochloremia were found in 35.5%, 13.7%, and 12.9% of patients. There were recorded a significant positive association between fasting blood glucose and serum urea, creatinine, and K+ concentration, between serum urea concentration and serum creatinine, K+, and Cl- concentrations, between serum creatinine and K+, and Cl- concentrations, and between serum Na+ and Cl- concentration, and a significant negative association between fasting blood glucose and serum Na+ and Cl- concentrations and between serum K+ and Na+ concentrations. Conclusion: It can be concluded that coronavirus infections induced increases in fasting blood glucose, serum urea, and creatinine, and a decrease in Na+ concentrations. There was a significant association between different parameters. These biochemical changes may help the clinicians to understand COVID-19 better and provide more clinical treatment options and prevent the serious complications of the disease. Thus, clinicians should pay special attention to fasting blood glucose, kidney function and electrolyte status of COVID-19 patients. Changes in fasting blood glucose, kidney function, and electrolyte levels can be a good indicator of disease progression.

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“…Electrolyte imbalance has been reported as a potential biomarker to predict disease severity and mortality in COVID-19 4,5 . In the studies performed, biochemistry parameters such as sodium, potassium, magnesium, calcium, and fasting blood sugar were measured during the COVID-19 disease process 6–8 . The progress of the disease may be highly dependent on the abnormality of the parameters listed above.…”

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confidence: 99%

Evaluation of the Effect of Biochemistry Parameters on the Clinical Course in COVID-19 Patients Who Received Tocilizumab Treatment

Duksal¹,

Burnik²,

Mermer³

et al. 2022

Southern Medical Journal

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Objectives: Patients who develop cytokine storm while they have coronavirus disease 2019 (COVID-19) experience more severe symptoms. This article aims to evaluate the effect of biochemical parameters on the clinical course of the disease in patients treated with tocilizumab (TCZ) due to cytokine storm.Methods: Medical documents of patients with COVID-19 were searched retrospectively. Patients who entered cytokine storm were classified as group 1 and divided into two subgroups as patients who were followed up in the ward and in the intensive care unit (ICU). Less severe COVID-19 patients who did not enter cytokine storm were included in the control group as group 2.Results: A total of 522 patients with COVID-19 infection were included in the study. The mean age was 62.0 ± 15.6 years, and the majority were male (64.4%). Hypertension and diabetes mellitus were the two most common diseases, seen in 50.8% and 29.9%, respectively. There were 392 patients with TCZ application (group 1) and 130 patients without TCZ (group 2). Significantly higher serum glucose, magnesium, and sodium and lower calcium levels were present in group 1 than in group 2 (<0.001). Hypocalcemia, hypernatremia, hypermagnesemia, and hyperkalemia were more frequently detected in the ICU compared with the patients treated in the wards (P = 0.001, P < 0.001, P = 0.039, and P < 0.001, respectively).Conclusions: Following up closely electrolyte disturbances may support patient survival and decrease the probability of ICU necessity. This approach should be taken before the development of important disorders to be effective in the treatment process of the main disease.

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Hyponatremia in COVID-19 patient using angiotensin type 1 receptor (AT1R) blocker and diuretic: a case report

Cited by 4 publications

References 5 publications

Evaluation of electrolyte status of sodium, potassium and magnesium, and fasting blood sugar at the initial admission of individuals with COVID-19 without underlying disease in Golestan Hospital, Kermanshah

Evaluation of electrolyte status of sodium, potassium and magnesium, and fasting blood sugar at the initial admission of individuals with COVID-19 without underlying disease in Golestan Hospital, Kermanshah

Effect of Coronavirus Infection on Fasting Blood Glucose, Kidney Function, and Electrolytes in COVID-19 Patients in the Zawia Region, Western Libya

Evaluation of the Effect of Biochemistry Parameters on the Clinical Course in COVID-19 Patients Who Received Tocilizumab Treatment

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