Hyponatremia: A Marker of Inflammation for COVID-19

We have read with great interest the article by Nair et al[1] in which they explain presence of two subphenotypes acute respiratory distress syndrome (ARDS) secondary to severe coronavirus 2 (SARS-CoV-2) through serum markers systemic inflammation such as ferritin (ferritin), lactate dehydrogenase (LDH) and C-reactive protein (CRP), are associated worse results terms days stay intensive care unit (ICU), mechanical ventilation, higher mortality; interleukin-6 (IL-6) is proinflammatory cytokine involved cascade damage. Therefore we share our experience research on other side world: under premise that elevated levels IL-6[2] favor non-osmotic secretion antidiuretic hormone (ADH) consequent hyponatremia this electrolyte disturbance could be another marker severity poor prognosis; therefore, SARS-CoV-2 would etiological agent IL-6 released recognized main inflammatory mediator phase hematological, immunological, endocrinological, metabolic effects.[3]