ABSTRACT
BACKGROUND: The Syndrome of Inappropriate Antidiuresis (SIADH) has been described to be associated with a multitude of conditions and medications, including the severe acute respiratory syndrome coronavirus 2. We describe the case of a patient with newly diagnosed and symptomatic SIADH after receiving the second COVID-19 vaccination not explained otherwise. CASE PRESENTATION: A 79-year-old male person was admitted to the emergency department due to a worsening of his general health state expressed by weakness, fatigue and anorexia. Vital signs and clinical findings were normal, in particular the patient was considered to be euvolemic. Laboratory investigations revealed a serum sodium of 117 mmol/L, a serum osmolality of 241 mosm/kg and a urea of 1.2 mmol/L with creatinine within normal range. Urine chemistry showed a urine osmolality of 412 mosm/kg and urine sodium of 110 mmol/L. TSH, C-reactive protein, and basal cortisol levels were normal. Under therapy with balanced crystalloid fluids, hyponatremia worsened and in absence of diuretic medications, diagnosis of SIADH was made. Since fluid restriction was not sufficiently effective, oral urea was administered. Under this therapy regimen hyponatremia resolved. CONCLUSIONS: Local as well as systemic reactions have been described for the new mRNA-based vaccines including pain and fever. Therefore, it is imaginable that the vaccine might trigger SIADH in some patients.
Subject(s)
COVID-19 , Hyponatremia , Inappropriate ADH Syndrome , Aged , COVID-19 Vaccines , Humans , Hyponatremia/etiology , Inappropriate ADH Syndrome/chemically induced , Male , SARS-CoV-2 , VaccinationABSTRACT
BACKGROUND: Coronavirus disease 2019 (COVID-19) is an acute virus infection, which was declared by the World Health Organization (WHO) as a pandemic. As a consequence, the Swiss government decreed a public lock-down to reduce and restrict further infections. The aim of this investigation was to provide the impact of the COVID-19 lock-down on the presentations of patients in an interdisciplinary emergency department (ED). PATIENTS, MATERIAL AND METHODS: A retrospective study was performed at an interdisciplinary Swiss ED during the lock-down period. All patients who presented to the ED were enrolled in this investigation and compared to a control cohort during the same time period in 2019. Data regarding patients' characteristics, medical specialty, time course of presentations during the observation period, outpatient or hospital admission were analyzed. RESULTS: In total 7072 patients were included in the final analysis. During the lock-down period the number of ED presentations significantly decreased by 29% in comparison to the control period in the previous year (pâ¯<â¯0.0001). The analysis of the time course revealed that in each week the number of patients was lower with 13-43% reduction. Irrespective of the medical specialty, the number of presentations decreased during the COVID-19 situation, whereas this decrease was higher in surgical diseases (31%, pâ¯<â¯0.0001) than in non-surgical presentations (3.6%, pâ¯= 0.4). CONCLUSION: The socioeconomic lock-down was associated with reduced number of presentations in an ED. Mainly, surgical diseases and injuries were affected in terms of a reduction of presentations during the COVID-19 lock-down period.
Subject(s)
COVID-19 , Communicable Disease Control , Emergency Service, Hospital , Humans , Retrospective Studies , SARS-CoV-2ABSTRACT
The emergence of the novel coronavirus or severe acute respiratory syndrome coronavirus 2 leads to a high number of cases of severe pneumonia. So far, little is known about the course of the disease and its symptoms, complications and treatment. We report the first two cases of the syndrome of inappropriate antidiuresis complicating COVID-19 pneumonia.