Severe Hyponatremia in the Setting of COVID-19-Associated Syndrome of Inappropriate Antidiuretic Hormone: A Case Report

Abstract

The COVID-19 pandemic has resulted in significant worldwide morbidity and mortality. One of the less studied clinical manifestations is Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) associated with COVID-19 pneumonia. We present a single case of COVID-19 pneumonia-associated SIADH in a 71-year-old male with a history of alcohol use disorder. This case highlights the importance of full diagnostic workup of the underlying cause of hyponatremia to avoid significant morbidity.

LWMH Use in Elderly Patient with Normal Kidney Function Affects Serum Sodium and Potassium Levels: A Case Report

“…Another possible reason for SIADH in COVID-19 might be due to use of dexamethasone in supportive treatment. This was reported to have an effect of more than a week of hyponatremia [9].…”

“…Pertinent studies from the time of admission included: sodium of 137 mmol/L (136 -145), potassium of 4.1 mmol/L (3.5 -5.1), magnesium of 1.9 mg/dL (1.9-2.7), and calcium of 8.2 mg/dL (8.6 -10.3), albumin of 3.0 gm/dL (3.5 -5.7), ALP of 82 IntUnit/L (34-104), ALT of 87 Intunits/L (7 -52), AST of 75 IntUnit/L (13-39), CK of 1009 IntUnit/L ( 30 -223), CKMB of 14.3 ng/mL (0.6 -6.3), TSH of 0.21 mIU/mL (0.45 -5.33), T4 free of 1.70 ng/dL (0.6-1.6), T3 free of 2.20 pg/mL (2.5-3.9), serum creatinine of 0.8 mg/dL (0.6 -1.2), blood urea nitrogen levels of 21 mg/dL (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25), and eGFR of > 60 mL/min/1.73m 2 .…”