Hyponatremia in new onset diabetic ketoacidosis: A comparative analysis before and during the COVID-19 pandemic

• Published in: Annales d'endocrinologie 2023-10, Vol.84 (5), p.573-573
• Main Authors: Gorchane, A., Ach, T., Sahli, J., Bel Hadj Slama, N., Ben Abdelkrim, A., Hasni, Y., Chadli Chaieb, M., Ach, K.
• Format: Article
• Language: English
• ISSN: 0003-4266
• DOI: 10.1016/j.ando.2023.07.181

The COVID-19 pandemic has been associated with electrolyte imbalances, including hyponatremia. Our objective was to compare electrolyte panel in patients presenting with new onset diabetic ketoacidosis (DKA) before and during the COVID-19 pandemic. We conducted a cross-sectional analytical study where we compared electrolyte panel of patients hospitalized with new onset DKA two years before and during COVID-19. The population was divided in two groups: G1: before COVID-19, G2: during COVID-19. Statistical analysis was made using SPSS software. Natremia and kalemia were adjusted according to glycemia and pH respectively. A total of 340 patients were included in this study. G1 counted 137 patients while G2 counted 203 patients. Hyponatremia was significantly more prevalent at first diagnosis of DKA in G2 compared to G1 (21.9% vs. 11.21%) (P=0.024). Median natremia was comparable between the two groups (138[136-140] in G1 vs. 138[135-140] in G2) (P=0.416). Hyponatremia during COVID-19 is found to be multifactorial due mostly to increased gastrointestinal loss (diarrhea, vomiting), decreased oral intake, or syndrome of inappropriate antidiuretic hormone secretion (SIADH). In the context of COVID-19, the development of SIADH may be caused by physical or psychological distress resulting from the disease, or it may be a result of non-osmotic release of antidiuretic hormone (ADH) secretion due to cytokine storm or IL-6 mediated effects which impairs the osmoregulatory mechanism of ADH in the brain, causing hyponatremia.