ABSTRACT
Background: In December 2019, pneumonia-like syndrome with unknown etiology was observed in China. Later on, a new coronavirus was identified, named SARS-CoV-2. We present a case of SARS-CoV-2 pneumonia complicated by severe hypernatriemia refractory to therapy. Description of the case: A 60-year-old man with mild dyspnea came at the DEA. He reported infection with SARS-CoV-2 from a week. He reported no medical history except for prostatic hypertrophy. At the entrance the patient was lucid, oriented and cooperative. The B.P. was 130/75 with pulse 75 bpm, apyretic, SpO2 88% on A.A. To DEA showed examinations: D-Dimer 291, fibrinogen 744, VES 84, PCR 21.4, Ferritin 17347, LDH 532, normal electrolytes. The EGA (Reservoir 60%) detected: pO2 61.8 mmHg, pCO2 42.7, pH 7.45, SpO2 89% and P/F 103. The Rx thorax showed multiple hazy parenchymal opacities in the lower lobar seat bilaterally. He was submitted to therapy based on dexamethasone, fluid therapy, antibiotics, enoxaparin. After 36 hours, he presented progressive deterioration of the cognitive state and blood tests showed hypernatriemia (154 mmol). He undergoing therapy, sodium (168 mmol) worsened . After six days he died. Conclusions: While the multisystem impact of SARS-CoV-2 has been well established only recently been described the incidence of the disruption of sodium homeostasis in patients with CoViD- 19. The peculiarity of this case-report is given by the early and serious hypernatriemia as an uncommon complication. This suggests that others processes related to CoViD-19 might be the mechanism of dysnatremias in hospitalized patients.