Symptomatic sinus bradycardia due to electrolyte imbalances in syndrome of inappropriate antidiuretic hormone (SIADH) related covid-19: a case report

Amir M., Renata A., Ratana L.T.

Departement of Cardiology and Vascular Medicine, Hasanuddin University, Makassar, Indonesia; Dr. Wahidin Sudirohusodo National General Hospital, Makassar, Indonesia


Abstract

Background: Coronavirus Disease-2019 (COVID-19) has been declared a global pandemic since March 11th, 2020. Despite emerging reports and literature covering a broad spectrum of COVID-19 clinical manifestations, facets of COVID-19 have not been fully elucidated. To the authors’ concern, sinus bradycardia as a manifestation of COVID-19-induced syndrome of inappropriate antidiuretic hormone (SIADH) has never been reported before. Case presentation: In this paper, we report a case of a 59-year-old male patient with confirmed COVID-19 initially presented with presyncope. Further investigations reveal sinus bradycardia related to COVID-19-induced SIADH. This case highlights the possibility of immuno-neuroendocrino-cardiovascular crosstalk resulting in an atypical manifestation of COVID-19: near syncope due to sinus bradycardia. Conclusions: Another possible cause of sinus bradycardia in COVID-19 is electrolyte imbalance due to COVID-19-related SIADH. © 2021, The Author(s).

COVID-19; Electrolyte imbalances; SIADH; Symptomatic sinus bradycardia


Journal

BMC Infectious Diseases

Publisher: BioMed Central Ltd

Volume 21, Issue 1, Art No 465, Page – , Page Count


Journal Link: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85106710467&doi=10.1186%2fs12879-021-06143-2&partnerID=40&md5=a1c6b2ababb93482e9360ce0c3805b6d

doi: 10.1186/s12879-021-06143-2

Issn: 14712334

Type: All Open Access, Gold, Green


References

(2020) Report of the WHO-China joint mission on coronavirus disease 2019 (COVID-19), , http://who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf; (2020) COVID-19 coronavirus, , www.worldometers.info/coronavirus/, www.worldometers.info/coronavirus/; Behzad, S., Aghaghazvini, L., Radmard, A.R., Gholamrezanezhad, A., Extrapulmonary manifestation of COVID-19: radiologic and clinical overview (2020) Clin Imaging, 66, pp. 35-41; Decaux, G., Musch, W., Clinical laboratory evaluation of the syndrome inappropriate secretion of antidiuretic hormone (2008) Clin J Am Nephrol, 3 (4), pp. 1175-1184; Yousaf, Z., Al-Shokri, D., Al-Soub, H., Mohamed, F.H., COVID-19-associated SIADH: a clue in the times of pandemic (2020) Am J Physiol Endocrinol Metab, 318 (6), pp. E882-E885; Habib, M.B., Sardar, S., Sajid, J., Acute symptomatic hyponatremia in setting of SIADH as an isolated presentation of COVID-19 (2020) IDCases, 21. , https://doi.org/10.1016/j.idcr.2020.e00859; Grant, A.O., Basic science for the clinical Electrophysiologist: cardiac ion channels (2009) Circ Arrhythm Electrophysiol, 2 (2), pp. 185-194; Amaratunga, E.A., Corwin, D.S., Moran, L., Snyder, R., Bradycardia in Patients with COVID-19: A Calm before the Storm?, , https://doi.org/10.7759/cureus.8599, Cureus. Cureus, Inc. 2020; Tantisattamo, E., Reddy, U.G., Duong, D.K., Ferrey, A.J., Ichii, H., Dafoe, D.C., Hyponatremia: a possible immuno-neuroendocrine interface with COVID-19 in a kidney transplant recipient (2020) Transpl Infect Dis, 8; Karabag, T., Kalayci, B., Sayin, M.R., Erten, T., Atrioventricular conduction defect associated with severe hyponatremia (2018) Med Pharmacy Rep Clujul Medical, 91 (3), pp. 342-345; Mouallem, M., Friedman, E., Shemesh, Y., Mayan, H., Pauzner, R., Farfel, Z., Cardiac conduction defect associated with hyponatremia (1991) Clin Cardiol, 14 (2), pp. 165-168; Trautwein, W., Generation and conduction of impulses in the heart as affected by drugs (1963) Pharmacol Rev, 15, pp. 277-332. , COI: 1:CAS:528:DyaF3sXks1Gjsb0%3D, PID: 13994011; Nikolaidou, T., Cai, X.J., Stephenson, R.S., Yanni, J., Lowe, T., Atkinson, A.J., Congestive heart failure leads to prolongation of the PR interval and atrioventricular junction enlargement and ion channel remodeling in the rabbit (2015) PLoS One, 10 (10); Ramanathan, S., McMeniman, J., Cabela, R., Holmes-Walker, D.J., Fung, V.S., SIADH and dysautonomia as the initial presentation of Guillain-Barré syndrome (2012) J Neurol Neurosurg Psychiatry, 83 (3), pp. 344-345; Nabin, A., Thapa, L.J., Paudel, R., Rana, P.V.S., Acute intermittent porphyria with SIADH and fluctuating dysautonomia (2012) Kathmandu Univ Med J, 38 (2), pp. 96-99; Hodax, J.K., Bialo, S.R., Yalcindag, A., SIADH in systemic JIA resolving after treatment with an IL-6 inhibitor (2018) Am Acad Pediatr, 141; Berni, A., Malandrino, D., Parenti, G., Maggi, M., Poggesi, L., Peri, A., Hyponatremia, IL-6, and SARS-CoV-2 (COVID-19) infection: may all fit together? (2020) J Endocrinol Investig, 43 (8), pp. 1137-1139

Indexed by Scopus

Leave a Comment