The syndrome of inappropriate antidiuresis in COVID-19 pneumonia: report of two cases

Ravioli, Svenja; Niebuhr, Norbert; Ruchti, Chantal; Pluess, Emanuel; Stoeckli, Thomas; Lindner, Gregor

doi:10.1093/ckj/sfaa080

Cited by 18 publications

(20 citation statements)

References 6 publications

(5 reference statements)

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“…Recently, hyponatremia has been reported as a common electrolyte disorder in COVID-19 patients [5][6]. Similar to our patient, the limited data have shown COVID-19 pneumonia as an underlying cause of syndrome of inappropriate antidiuretic hormone secretion (SIADH) induced hyponatremia [7][8]. SIADH is a diagnosis of exclusion characterized by dilutional hyponatremia in the absence of any identifiable renal pathology, diuretics intake, or any other no-osmotic stimulating factors for antidiuretic hormone (ADH) production [9][10].…”

Section: Introductionsupporting

confidence: 81%

COVID-19 Pneumonia: An Emerging Cause of Syndrome of Inappropriate Antidiuretic Hormone

Sheikh¹,

Ahmad²,

Jeelani³

et al. 2020

Cureus

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Syndrome of inappropriate antidiuretic hormone (SIADH) is the leading cause of hyponatremia. We, herein, report a case of a patient with coronavirus disease-2019 (COVID-19) who developed sudden exertional dyspnea and hypoxia and was found to be hyponatremic. A diagnosis of SIADH was made due to COVID-19 pneumonia. The patient was managed conservatively with a significant improvement during the course of hospitalization and on follow-up.

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Section: Introductionsupporting

confidence: 81%

COVID-19 Pneumonia: An Emerging Cause of Syndrome of Inappropriate Antidiuretic Hormone

Sheikh¹,

Ahmad²,

Jeelani³

et al. 2020

Cureus

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“…(2) Dysfunction or injury of other organs and systems may also cause complications that require nephrological consultation as well as negatively impact on kidney injury. Frequent examples are SIADH secretion causing hyponatraemia [ 15 ], lung disease–related hypoxaemia and inflammation aggravating AKI and heart disease causing a cardiorenal syndrome [ 14 ]. In fact, COVID-19-related kidney injury may also aggravate heart failure.…”

Section: Electrolyte Abnormalities and Kidney Injury In Covid-19mentioning

confidence: 99%

“…Hyponatraemia is common in COVID-19 patients and the cause appears to be outside the kidneys, as occurrence of the syndrome of inappropriate antidiuretic hormone (SIADH) has been well characterized by Ravioli et al [ 15 ]. This observation is in line with previous experience with other forms of pneumonia, as hyponatraemia (serum sodium ≤130 mmol/L) was found in 8% of patients with community-acquired pneumonia, with nearly half of the cases having SIADH [ 16 ].…”

Section: Syndrome Of Inappropriate Antidiuretic Hormonementioning

confidence: 99%

Kidney disease and electrolytes in COVID-19: more than meets the eye

Carriazo

Kanbay

Ortíz

2020

Clinical Kidney Journal

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COVID-19 is a global pandemic fuelled in some countries by government actions. The current issue of Clinical Kidney Journal presents 15 articles on COVID-19 and kidney disease from three continents, providing a global perspective of the impact of severe acute respiratory syndrome coronavirus 2 on electrolytes and different kidney compartments (glomeruli, tubules and vascular compartments) and presenting clinically as a syndrome of inappropriate antidiuretic hormone secretion, acute kidney injury, acute kidney disease, collapsing glomerulopathy and thrombotic microangiopathy, among others, in the context of a brand-new cardiorenal syndrome. Kidney injury may need acute dialysis that may overwhelm haemodialysis (HD) and haemofiltration capabilities. In this regard, acute peritoneal dialysis (PD) may be lifesaving. Additionally, pre-existent chronic kidney disease increases the risk of more severe COVID-19 complications. The impact of COVID-19 on PD and HD patients is also discussed, with emphasis on preventive measures. Finally, current therapeutic approaches and potential future therapeutic approaches undergoing clinical trials, such as complement targeting by eculizumab, are also presented.

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“…It is divided into euvolemic, hypovolemic, and hypervolemic hyponatremia, each of which is treated differently [14]. In COVID-19, hyponatremia is common and its etiology is not clear, probably is multifactorial not only be associated with pneumonia but also with the gastrointestinal symptoms of this infection and could appears to be outside the kidneys, as it happens in SI-ADH [15,16]. The most common cause of hyponatremia is the SIADH, which accounts for up to 40-50% of cases, but the prevalence may be higher in some pathological conditions, such as subarachnoid hemorrhage, traumatic brain injury, and pneumonia.…”

Section: Syndrome Of Inappropriate Antidiuretic Hormone In Covid-19mentioning

confidence: 99%

“…In this case the treatment was only directed at SARS-CoV-2. Ravioli, et al [15], report 2 cases of SIADH in COVID-19 pneumonia, showing a new complication of this emerging infectious disease. Also, Ho KS, et al [16], report a first case of SARS-CoV-2 induced syndrome of SIADH manifesting as new-onset seizures.…”

Section: Syndrome Of Inappropriate Antidiuretic Hormone In Covid-19mentioning

confidence: 99%

Untitled

2020

J Clin Nephrol Ren Care

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CoMMentARy of RNA beta-coronavirus, which include the virus that were responsible for the outbreaks of severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS) between 2012 and 2013 [3,4]. COVID-19 has a variable mortality rate according to each country and is expected to affect a major part of the world's population [2]. The clinical spectrum of COVID-19 infection is variable, ranging from asymptomatic carrier state, anosmia, ageusia or minor upper respiratory tract illness to severe pneumonia potentially leading to acute respiratory distress syndrome (ARDS), respiratory failure, multiple organ disfunction and even death [5]. Diarrhea and cutaneous and thrombotic manifestations were recently described [6]. SARS-CoV-2 mainly affects the respiratory system causing acute respiratory illness, with bilateral and diffuse pneumonia, but it can affect multiple organs and systems, such as the kidneys [6]. Kidney cells express receptors and enzymes required for viral entry, such as angiotensin-converting enzyme 2 (ACE2), which is also expressed in the lung, heart and intestine [7,8]. Furthermore, kidney damage may result from hemodynamic factors or dysfunctional immune response. Direct renal cell infection is possible and is supported by some studies showing viral particles within proximal tubules and podocytes [9], as indicated by presence of proteinuria and hematuria. Inflammatory cytokines have long been known to induce acute kidney injury (AKI), glomerulopathy [10], and a spectrum of

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The syndrome of inappropriate antidiuresis in COVID-19 pneumonia: report of two cases

Cited by 18 publications

References 6 publications

COVID-19 Pneumonia: An Emerging Cause of Syndrome of Inappropriate Antidiuretic Hormone

COVID-19 Pneumonia: An Emerging Cause of Syndrome of Inappropriate Antidiuretic Hormone

Kidney disease and electrolytes in COVID-19: more than meets the eye

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