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10.1530/EJE-21-0596

http://scihub22266oqcxt.onion/10.1530/EJE-21-0596
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34292875!8428073!34292875
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suck abstract from ncbi


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pmid34292875      Eur+J+Endocrinol 2021 ; 185 (4): G35-G42
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  • ENDOCRINOLOGY IN THE TIME OF COVID-19-2021 UPDATES: The management of diabetes insipidus and hyponatraemia #MMPMID34292875
  • Christ-Crain M; Hoorn EJ; Sherlock M; Thompson CJ; Wass J
  • Eur J Endocrinol 2021[Aug]; 185 (4): G35-G42 PMID34292875show ga
  • COVID-19 has changed the nature of medical consultations, emphasizing virtual patient counselling, with relevance for patients with diabetes insipidus (DI) or hyponatraemia. The main complication of desmopressin treatment in DI is dilutional hyponatraemia. Since plasma sodium monitoring is not always possible in times of COVID-19, we recommend to delay the desmopressin dose once a week until aquaresis occurs allowing excess retained water to be excreted. Patients should measure their body weight daily. Patients with DI admitted to the hospital with COVID-19 have a high risk for mortality due to volume depletion. Specialists must supervise fluid replacement and dosing of desmopressin. Patients after pituitary surgery should drink to thirst and measure their body weight daily to early recognize the development of postoperative SIAD. They should know hyponatraemia symptoms. Hyponatraemia in COVID-19 is common with a prevalence of 20-30% and is mostly due to SIAD or hypovolaemia. It mirrors disease severity and is an early predictor of mortality. Hypernatraemia may also develop in COVID-19 patients, with a prevalence of 3-5%, especially in ICU, and derives from different multifactorial reasons, for example, due to insensible water losses from pyrexia, increased respiration rate and use of diuretics. Hypernatraemic dehydration may contribute to the high risk of acute kidney injury in COVID-19. IV fluid replacement should be administered with caution in severe cases of COVID-19 because of the risk of pulmonary oedema.
  • |Ambulatory Care/methods/standards[MESH]
  • |COVID-19/*epidemiology[MESH]
  • |Consensus[MESH]
  • |Diabetes Insipidus/epidemiology/pathology/*therapy[MESH]
  • |Distance Counseling/methods/standards[MESH]
  • |Endocrinology/history/*standards/trends[MESH]
  • |Expert Testimony[MESH]
  • |History, 21st Century[MESH]
  • |Hospitalization/statistics & numerical data[MESH]
  • |Humans[MESH]
  • |Hyponatremia/epidemiology/pathology/*therapy[MESH]
  • |Pandemics[MESH]
  • |Practice Patterns, Physicians'/history/standards/trends[MESH]
  • |SARS-CoV-2[MESH]
  • |Severity of Illness Index[MESH]


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