Urinary Retention and Severe Hyponatremia: An Unusual Presentation of COVID-19

Saleh, Ahmed Osman; Al-Shokri, Shaikha D.; Ahmed, Afif; Musa, Ahmed Elmustafa; Mohamed, Mouhand

doi:10.12890/2020_001905

Cited by 4 publications

(2 citation statements)

References 9 publications

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“…Moreover, the prospective evaluation of 90,889 hospitalized adult patients demonstrated that mixed dysnatremia, hospital-acquired hypernatremia, persistent hypernatremia and 'hyponatremia overcorrected to hypernatremia' were independent indicators of in-hospital mortality ( 23 ). In the last case, the life-threatening occurrence of osmotic demyelination should not be forgotten and has been documented also in a case of overcorrected COVID-19-related SIAD ( 37 ).…”

Section: Discussionmentioning

confidence: 94%

Sodium alterations impair the prognosis of hospitalized patients with COVID-19 pneumonia

Martino¹,

Falcioni²,

Giancola³

et al. 2021

Endocrine Connections

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Objective: Dysnatremia is common in hospitalized patients, often worsening the prognosis in pneumopathies and critical illnesses. Information on COVID-19-related hyponatremia is partially conflicting, whereas data on hypernatremia in this context are scarce. We assessed, in a cohort of COVID-19 inpatients: the prevalence of sodium alterations at admission and throughout their hospitalization; their association with inflammation/organ damage indexes; their short-term prognostic impact. Study design and methods: 117 patients (81 males, 64±13 years) hospitalized for COVID-19 between 1st March and 30th April 2020 were retrospectively followed-up for their first 21 days of stay by collecting all serum sodium measurements, basal CRP and serum lactate levels, maximum IL-6 and information on care setting, required ventilation, length of hospitalization, in-hospital death. Results: At admission, 26.5% patients had hyponatremia, 6.8% had hypernatremia. During their hospitalization, 13.7% patients experienced both disorders (“mixed dysnatremia”). Lower sodium levels at admission were correlated with higher CRP (p=0.039) and serum lactate levels (p= 0.019), but not IL-6. Hypernatremia and a wider sodium variability were associated to maximum required ventilation, need of ICU assistance and duration of the hospitalization. Mean estimated time to ICU admission was 20 days shorter in patients exposed to sodium alterations at any time of their hospital course (Log-Rank test p=0.032). Conclusions: Sodium alterations frequently affect hospitalized COVID-19 patients. Hyponatremia could indicate pulmonary involvement, whereas hypernatremia is associated to prolonged hospitalization and need for intensive care/mechanical ventilation, particularly when resulting from prior hyponatremia. Optimizing in-hospital sodium balance is crucial to improve patients’ prognosis.

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Section: Discussionmentioning

confidence: 94%

Sodium alterations impair the prognosis of hospitalized patients with COVID-19 pneumonia

Martino¹,

Falcioni²,

Giancola³

et al. 2021

Endocrine Connections

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“…The syndrome of inappropriate antidiuretic hormone (SIADH) has been associated with SARS-CoV-2 acute infection in adults, but the etiology is unknown. 4,5 Hypercytokinemia activating the nonosmotic secretion of ADH and damage to the lung tissue stimulating ADH secretion via hypoxic pulmonary hypoconstriction have been postulated. 4 To our knowledge, SIADH has not been previously described as a complication of MIS-C.…”

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confidence: 99%

Hyponatremia in Patients With Multisystem Inflammatory Syndrome in Children

Mills

Trivedi

Tremoulet

et al. 2021

Pediatric Infectious Disease Journal

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We report 2 patients with multisystem inflammatory syndrome in children with evidence of hyponatremia on admission. Despite fluid resuscitation and resolution of dehydration, the hyponatremia worsened. Serum and urine studies were evaluated and demonstrated evidence of syndrome of inappropriate antidiuretic hormone. Fluid restriction and anti-inflammatory therapy were initiated with resolution of hyponatremia.

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