Is There a Relationship between COVID-19 and Hyponatremia?

Abstract

Nowadays, humanity faces one of the most serious health crises, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. The severity of coronavirus disease 2019 (COVID-19) pandemic is related to the high rate of interhuman transmission of the virus, variability of clinical presentation, and the absence of specific therapeutic methods. COVID-19 can manifest with non-specific symptoms and signs, especially among the elderly. In some cases, the clinical manifestations of hyponatremia may be the first to appear. The pathophysiological mechanisms of hyponatremia among patients with COVID-19 are diverse, including syndrome of inappropriate antidiuretic hormone secretion (SIADH), digestive loss of sodium ions, reduced sodium ion intake or use of diuretic therapy. Hyponatremia may also be considered a negative prognostic factor in patients diagnosed with COVID-19. We need further studies to evaluate the etiology and therapeutic management of hyponatremia in patients with COVID-19.

The Prognostic Value of Hyponatremia for Predicting Poor Outcome in Patients With COVID-19: A Systematic Review and Meta-Analysis

“…Interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF) play a pivotal role in the development of sepsis. IL-6 has an inverse correlation with serum sodium which has a mechanism to stimulate hypothalamic arginine vasopressin (9)(10)(11)(12). Several studies showed that pneumonia is associated with syndrome of inappropriate antidiuretic hormone (11,13,14); this mechanism may cause hyponatremia.…”

COVID-19 Pneumonia Complicated by Seizure Due to Severe Hyponatremia

“…It can result from low oral intake of fluids, diarrhea, diuretics, and in many instances, it has been attributed to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Symptoms of hyponatremia such as nausea, dizziness, and headache have been reported in COVID-19 [4]. However, seizure in the context of COVID-19associated hyponatremia, to the best of our knowledge, was not previously reported.…”

“…SIADH is diagnosed by a combination of supportive laboratory tests (including serum and urine sodium level, serum and urine osmolality) and the exclusion of other causes of hyponatremia [6]. COVID-19 related hyponatremia was reported frequently in COVID-19 patients, and it could be the only presenting manifestation [4,7]. The mechanism of COVID-19-induced SIADH is not well elucidated, but it was postulated that inflammatory cytokine release [4], stress, intravascular volume depletion, lower osmolarity, and ventilation perfusion-mismatch play a role in dysregulating the antidiuretic hormone (ADH) release [8].…”

“…The mechanism of COVID-19-induced SIADH is not well elucidated, but it was postulated that inflammatory cytokine release [4], stress, intravascular volume depletion, lower osmolarity, and ventilation perfusion-mismatch play a role in dysregulating the antidiuretic hormone (ADH) release [8]. Many patients respond to fluids restriction and treatment of the underlying precipitant [4].…”

Selected Respiratory Protective Devices: Respirators and Significance of Some Markings

“…In this case, it is addressed a so-called droplet infection, which is transmitted through the air. Coronavirus is spread through the air not only by droplets but also by aerosols [22]. Spreading of the aerosols is more dangerous because they are smaller particles than droplets [21,23].…”