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1.
Pan Afr Med J ; 39: 199, 2021.
Article in English | MEDLINE | ID: covidwho-1449267

ABSTRACT

Coronavirus disease 2019 (COVID-19) was first reported in December 2019. The disease is caused by severe acute respiratory syndrome virus corona virus 2 (SARS-CoV-2). Mild respiratory symptoms are the most common manifestations of SARS-CoV-2, but new signs are constantly being discovered as it spreads. Disorders of sodium balance are increasingly described in patients with SARS-CoV-2. We report, here, the cases of two patients presented with COVID-19 and in whom we discovered sodium disorders. The first patient is a 74-year-old man who presented with fatal hypernatremia. The second patient is a 66-years-old man presented with COVID-19 and euvolemic hyponatremia attributed to syndrome of inappropriate anti-diuretic hormone secretion (SIADH). This hyponatremia persisted long after the respiratory signs disappeared. Sodium balance disorders are increasingly described in the literature; special attention should be paid to the electrolyte status of COVID-19 patients. Pathophysiological mechanisms associating SARS-CoV-2 with these disorders are being studied.


Subject(s)
COVID-19/complications , Hypernatremia/virology , Inappropriate ADH Syndrome/virology , Aged , Fatal Outcome , Humans , Hypernatremia/diagnosis , Hyponatremia/diagnosis , Hyponatremia/virology , Inappropriate ADH Syndrome/diagnosis , Male , Sodium/blood
2.
Am J Case Rep ; 22: e930135, 2021 Mar 24.
Article in English | MEDLINE | ID: covidwho-1148367

ABSTRACT

BACKGROUND During the coronavirus disease 2019 (COVID-19) pandemic of 2020, varied presentations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported. The present report is of a case of hyponatremia and encephalopathy due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH) as the main presentation of SARS-CoV-2 infection in a 55-year-old woman. CASE REPORT A 55-year-old woman with type II diabetes mellitus presented with confusion and slurring of speech, with a temperature of 38.5°C, heart rate of 120 bpm, blood pressure of 159/81 mmHg, and oxygen saturation of 98% on room air. She did not have edema on examination. Laboratory testing showed a low sodium level of 116 mEq/L (reference range, 135-145 mEq/L) with urine osmolarity of 364 mOsm/kg, urinary sodium of 69 mEq/L, urinary potassium of 15.6 mEq/L, and serum osmolarity of 251 mOsm/kg. The patient had normal serum thyroid-stimulating hormone and cortisol levels. A chest X-ray should no pulmonary infiltrates nor did a lumbar puncture reveal signs of infection. A real-time SARS-CoV-2 polymerase chain reaction assay was positive for COVID-19. Brain imaging with computed tomography was negative for acute infarct, intracranial hemorrhage, and mass effect. Based on findings from laboratory testing and physical examination, a diagnosis of SIADH was made. The patient was treated with 3% hypertonic saline, followed by salt tablets and fluid restriction, with improvement in her clinical symptoms and serum sodium level. CONCLUSIONS The present report is of a rare but previously reported association with SARS-CoV-2 infection. Encephalopathy and hyponatremia associated with SIADH without pneumonia or other symptoms of infection should be an indication for testing for SARS-CoV-2 infection.


Subject(s)
Brain Diseases/virology , COVID-19/complications , Hyponatremia/virology , Inappropriate ADH Syndrome/virology , COVID-19/diagnosis , Diabetes Mellitus, Type 2/complications , Female , Humans , Middle Aged , Saline Solution, Hypertonic/therapeutic use , Sodium/blood , Sodium Chloride/therapeutic use
3.
J Neurovirol ; 26(5): 797-799, 2020 10.
Article in English | MEDLINE | ID: covidwho-1070964

ABSTRACT

There is concern that the global burden of coronavirus disease of 2019 (COVID-19) due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection might yield an increased occurrence of Guillain-Barré syndrome (GBS). It is currently unknown whether concomitant SARS-CoV-2 infection and GBS are pathophysiologically related, what biomarkers are useful for diagnosis, and what is the optimal treatment given the medical comorbidities, complications, and simultaneous infection. We report a patient who developed severe GBS following SARS-CoV-2 infection at the peak of the initial COVID-19 surge (April 2020) in New York City and discuss diagnostic and management issues and complications that may warrant special consideration in similar patients.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/complications , Guillain-Barre Syndrome/complications , Hyponatremia/complications , Pneumonia, Viral/complications , Acute Disease , Aged , Anticoagulants/therapeutic use , COVID-19 , Coronavirus Infections/pathology , Coronavirus Infections/therapy , Coronavirus Infections/virology , Disease Progression , Enoxaparin/therapeutic use , Female , Guillain-Barre Syndrome/pathology , Guillain-Barre Syndrome/therapy , Guillain-Barre Syndrome/virology , Humans , Hyponatremia/pathology , Hyponatremia/therapy , Hyponatremia/virology , New York City , Pandemics , Plasmapheresis , Pneumonia, Viral/pathology , Pneumonia, Viral/therapy , Pneumonia, Viral/virology , SARS-CoV-2
4.
Am J Case Rep ; 21: e925779, 2020 Aug 13.
Article in English | MEDLINE | ID: covidwho-713485

ABSTRACT

BACKGROUND Coronavirus disease 2019 (COVID-19) infection commonly presents as fever, cough, and shortness of breath in adults. Children are thought to have milder respiratory symptoms and to recover more quickly. We describe a new presentation of COVID-19 infection in children consisting of multisystem inflammation with decreased left ventricular function and evidence of lung disease. CASE REPORT Three children presented with fever, conjunctivitis, dry and cracked lips, rash, and/or cervical lymphadenopathy for at least 5 days. Two of these children required mechanical ventilation, and 1 of the 2 needed extracorporeal membrane oxygenation (ECMO) to support cardiorespiratory function. All of these children had moderate to severe hyponatremia and lymphopenia, which is usually seen in COVID-19. They were treated with intravenous immunoglobulin and high-dose aspirin. All of the children recovered. CONCLUSIONS Early recognition of children with multisystem inflammation is important because they are at increased risk for deterioration. Treatment with intravenous immunoglobulin and aspirin was used because this regimen has been shown to be beneficial in vasculitis of Kawasaki disease. The development of shock due to cardiac involvement may require ECMO.


Subject(s)
Betacoronavirus , Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , Systemic Inflammatory Response Syndrome/virology , Antipyretics/therapeutic use , Aspirin/therapeutic use , COVID-19 , Child , Child, Preschool , Conjunctivitis/therapy , Conjunctivitis/virology , Coronavirus Infections/therapy , Exanthema/therapy , Exanthema/virology , Extracorporeal Membrane Oxygenation , Female , Fever/therapy , Fever/virology , Heart Failure/therapy , Heart Failure/virology , Humans , Hyponatremia/therapy , Hyponatremia/virology , Immunoglobulins, Intravenous , Lymphadenopathy/therapy , Lymphadenopathy/virology , Lymphopenia/therapy , Lymphopenia/virology , Male , Pandemics , Pneumonia, Viral/therapy , Respiration, Artificial , SARS-CoV-2 , Systemic Inflammatory Response Syndrome/diagnosis , Systemic Inflammatory Response Syndrome/therapy , Vasculitis/therapy , Vasculitis/virology
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