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.

中文翻译：

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COVID-19-2021 更新期间的内分泌学：尿崩症和低钠血症的管理。

COVID-19 改变了医疗咨询的性质，强调了与尿崩症 (DI) 或低钠血症患者相关的虚拟患者咨询。去氨加压素治疗 DI 的主要并发症是稀释性低钠血症。由于在 COVID-19 期间并不总是可以监测血浆钠，我们建议每周推迟一次去氨加压素剂量，直到出现水样排泄，从而排出多余的滞留水。患者应每天测量体重。因 COVID-19 入院的 DI 患者因容量不足而死亡的风险很高。专家必须监督补液和去氨加压素的给药。垂体手术后患者应饮以止渴并每天测量体重，以及早识别术后SIAD的发展。他们应该知道低钠血症的症状。COVID-19 中的低钠血症很常见，患病率为 20-30%，主要是由于 SIAD 或低血容量。它反映了疾病的严重程度，是死亡率的早期预测指标。COVID-19 患者也可能出现高钠血症，患病率为 3-5%，尤其是在 ICU 中，并且由不同的多因素原因引起，例如，由于发热引起的无意识失水、呼吸频率增加和使用利尿剂。高钠血症脱水可能导致 COVID-19 急性肾损伤的高风险。由于存在肺水肿的风险，在 COVID-19 的严重病例中应谨慎进行静脉补液。它反映了疾病的严重程度，是死亡率的早期预测指标。COVID-19 患者也可能出现高钠血症，患病率为 3-5%，尤其是在 ICU 中，并且由不同的多因素原因引起，例如，由于发热引起的无意识失水、呼吸频率增加和使用利尿剂。高钠血症脱水可能导致 COVID-19 急性肾损伤的高风险。由于存在肺水肿的风险，在 COVID-19 的严重病例中应谨慎进行静脉补液。它反映了疾病的严重程度，是死亡率的早期预测指标。COVID-19 患者也可能出现高钠血症，患病率为 3-5%，尤其是在 ICU 中，并且由不同的多因素原因引起，例如，由于发热引起的无意识失水、呼吸频率增加和使用利尿剂。高钠血症脱水可能导致 COVID-19 急性肾损伤的高风险。由于存在肺水肿的风险，在 COVID-19 的严重病例中应谨慎进行静脉补液。高钠血症脱水可能导致 COVID-19 急性肾损伤的高风险。由于存在肺水肿的风险，在 COVID-19 的严重病例中应谨慎进行静脉补液。高钠血症脱水可能导致 COVID-19 急性肾损伤的高风险。由于存在肺水肿的风险，在 COVID-19 的严重病例中应谨慎进行静脉补液。