Dysgeusia in Covid-19 Patient: A Rare Cause of Hyponatremia

Background: Dysgeusia is a disturbance of taste and considered one of the oral symptoms of coronavirus infection (Covid-19). Hyponatremia can be induced by excessive water drinking due to dysgeusia. Case report: Thirty-two years old Indian male patient admitted to Mesaieed Hospital at Hamad Medical Corporation, Qatar. The patient was admitted during the second wave of pandemic because of mild to moderate Covid-19 pneumonia. The patient experienced cough and fever associated with hyposmia and dysgeusia, the later manifested by a bitterness sensation of tongue. The patient received medications according to the protocol, after two days of treatment his blood laboratory results showed hyponatremia (129 mmol/L) compared to the initial reading. Hyponatremia workup excluded the syndrome of inappropriate antidiuretic hormone secretion (SIADH). History revealed that the patient was drinking large amounts of water, around 4-5 liters/day because of bitterness sensation of tongue, the provisional diagnosis was dilutional hyponatremia, fluid restriction up to 1.5 liter/ day which showed dramatic improvement of his sodium blood level. Conclusion: Hyponatremia is not only secondary to SIADH in Covid-19 patients, but it can be due to other etiologies. Hyponatremia due to excessive water intake as part of dysgeusia is considered an extremely rare reported case.