SARS-COV-2, the virus responsible for coronavirus disease 2019 , has been associated with various clinical manifestations ranging from an asymptomatic carrier state to pneumonia and respiratory failure, encephalopathy, thromboembolic events, and death. The objective of this case report is to highlight an additional complication possible with COVID-19: central diabetes insipidus (CDI) in the setting of fulminant cerebral edema. A 66-year-old male presented with cough, shortness of breath, and fever and was found to have COVID-19 pneumonia. During the hospitalization, he developed acute hypernatremia with a significant increase in urine output associated with low urine osmolarity. Central diabetes insipidus was confirmed by administration of desmopressin. The presence of CDI along with worsening neurologic changes prompted cerebral imaging revealing intraparenchymal hemorrhages and significant edema. To our knowledge, this is the first report of CDI caused by cerebral edema in a patient with COVID-19. We present this rare association to help alert clinicians to the possibility of polyuria and CDI as a sign of potentially fatal neurologic sequelae of COVID-19.
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