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Lithium Toxicity in Two Coronavirus Disease 2019 (COVID-19) Patients

Kulachanya Suwanwongse1, Nehad Shabarek1

  • 1Internal Medicine, Lincoln Medical Center, New York City, USA.

Cureus
|July 9, 2020
PubMed

Insights

This study highlights a potential link between COVID-19 infection and lithium toxicity. Monitoring lithium levels in patients with coronavirus disease 2019 is crucial for prompt management.

Area of Science:

  • Psychiatry
  • Infectious Diseases
  • Clinical Toxicology

Background:

  • Coronavirus disease 2019 (COVID-19) is a global pandemic with significant morbidity and mortality.
  • Co-morbidities impact COVID-19 outcomes, but the role of psychiatric conditions and treatments remains under-explored.
  • Lithium, a vital psychiatric medication, has a narrow therapeutic index and is prone to toxicity due to various factors, including infections.

Observation:

  • Two patients with COVID-19 presented with symptoms suggestive of lithium toxicity.
  • No prior reports have documented the co-occurrence of COVID-19 and lithium toxicity.
  • These cases underscore the potential for infections like COVID-19 to precipitate lithium intoxication.

Findings:

  • COVID-19 infection may alter lithium levels, increasing the risk of toxicity.
  • Prompt recognition and management of lithium toxicity are essential in patients with COVID-19.
  • The study suggests a need for heightened vigilance regarding lithium levels in this patient population.

Implications:

  • Clinicians should consider monitoring lithium levels in all patients diagnosed with COVID-19 who are on lithium therapy.
  • This finding necessitates a re-evaluation of psychiatric medication management during viral pandemics.
  • Further research is warranted to elucidate the mechanisms linking COVID-19 and lithium pharmacokinetics.

Keywords:
akicase reportcorona virus diseasecovidkidney failurelithiumtoxicity

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