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Abstract: SA-PO722

Etiology of Severe Hyponatremia in COVID-19 Patients Compared with Hyponatremia with Non-COVID-19 Patients by Urine Osmolarity and Sodium

Session Information

Category: Fluid, Electrolytes, and Acid-Base Disorders

  • 1102 Fluid, Electrolyte, and Acid-Base Disorders: Clinical


  • Pak, Isaac, Westchester Medical Center, Valhalla, New York, United States
  • Durosier Louis, Miniolla, Westchester Medical Center, Valhalla, New York, United States
  • Kore, Shruti, Westchester Medical Center, Valhalla, New York, United States
  • Beck, James, Westchester Medical Center, Valhalla, New York, United States
  • Coritsidis, George N., Westchester Medical Center, Valhalla, New York, United States

Lung diseases are known to be associated with hyponatremia and the Syndrome of Inappropriate Antidiuretic Hormone (SIADH) . As COVID-19 cases surged during the pandemic, hyponatremia among COVID-19 cases were reported, suggesting an increase in the incidence of
SIADH .This study attempts to evaluate for potential causes of severe hyponatremia ( HN) prior and during the COVID-19 pandemic.


Single center, observational retrospective study comparing severe HN ( serum sodium 125 mEq/L or less) presenting to Westchester Medical Center Emergency room between 2019- 2022. Demographic variables, urine osmolarity (Uosm), urine sodium (UNa) were collected from EMR. COVID-19 infections were diagnosed by PCR. A total of 477 charts were reviewed. Patients were divided in two groups, severe HN without COVID-19 in the year of 2019 and those with COVID-19 between 2020 and 2022.


38 patients presented with severe HN and COVID-19 compared to 105 Non- COVID-19 patients in 2019. Complete urinary measurements were found in 26 COVID-19 patients & 66 Non-COVID-19 patients. 16 out of 26 COVID-19 patients preented with concentrated urine, Uosm >300. In patient with Uosm >300 Osm/kgH20 and UNa >20 Meq/L, 31% were COVID-19 positive and 24% Non-COVID -19, In patient with Uosm >300 and UNa < 20, 31% were COVID-19 positive compared to 33% Non COVID-19. Of those presenting with dilute urine Uosm <300, 38% were COVID-19 patients & 42% were Non-COVID-19 patients.


Severe Hyponatremia among COVID-19 and Non COVID-19 patients did not show a significant difference in etiology when comparing predictors Uosm and UNa. Despite other reports suggesting a higher incidence of SIADH, this was not evident in our severe HN COVID-19 patients.