Hyponatremia in COVID-19 Patients With Adrenal Insufficiency and Its Relation to Mortality and Survival Scores.

Hyponatremia is the most prevalent hydroelectrolytic disorder in clinical practice, and is linked to higher rates of morbidity and mortality. 1, 2.Sodium balance disorder, particularly hyponatremia, is a common condition among hospitalized patients with COVID-19 . and it is associated with a higher risk of morbidity, mortality, and disability. Acute hyponatremia causes serious brain swelling that can lead to permanent disability or death. Chronic hyponatremia causes attention deficit, gait instability, and osteoporosis, Mechanisms of hyponatremia in coronavirus disease 2019 (COVID-19) patients. Osmotic syndrome of inappropriate antidiuretic hormone release (SIADH) as a major mechanism. Also hypovolemic hyponatremia that may have been common in COVID-19 patients since nausea, vomiting, diarrhea.we predict critical illness-related corticosteroid insufficiency (CIRCI) play a role in hyponatremia in COVID-19 , high percentage of critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection in the study were treated with vasopressors (2). Angiotensin-converting enzyme 2 receptor and transmembrane serine protease 2 serine protease were colocalized in adrenocortical cells in the zona fasciculata and zona reticularis (2). plasma cortisol concentrations will be collected in critically ill patients with COVID-19 (2). The cortisol levels of critically ill patients with COVID-19 were low(2).We aimed to identify the previlence and mortality rate of hyponatremia in covid 19 patient with adrenal insufficiency . Our studies will present in Assiut hospital university on patients in isolation ward from October 2021 to October 2022.