Clinical Characteristics of DKA in Patients with COVID-19 Infection: A Case Series
Shahrokh Sadeghi Boogar
Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Faezeh Sehatpour *
Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Samin Ranjbar
Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Seyed Reza Kasaee
Shiraz Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences. Shiraz, Iran.
Sareh Mosleh-Shirazi
Department of Materials Science and Engineering, Shiraz University of Technology, Shiraz, Iran.
Farnaz Kamali Haghigh Shirazi
Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Rozita Sahraeyan
Shiraz Obstetrics and Gynecology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
*Author to whom correspondence should be addressed.
Abstract
Backgrounds: Diabetes mellitus (DM) is one of the co-morbidities that can increase the mortality rate of COVID-19 patients. The characteristics of patients who present with diabetic ketoacidosis (DKA) and COVID-19 co-morbidity have not been reviewed sufficiently.
Objectives: To investigate the characteristics and outcome of DKA in patients with COVID19 infection.
Methods: In this study, we describe 7 patients admitted to our department with impressions of DKA and concomitant COVID-19. Patients’ lab data, imaging and outcomes were documented in full detail.
Results: The Average of initial random blood sugar and serum HCO3 was 463.71mg/dl and 9.47mmol/L, respectively, among the patients in this survey. The majority of the patients (71%) were presented with DKA symptoms rather than respiratory symptoms related to COVID-19. Four patients expired in this survey. Of the four patients who were expired, all of them presented with moderate DKA, one of them had mild lung involvement, one moderate and two were in a severe category. The average of C-reactive protein (CRP) and Lactate dehydrogenase (LDH) were >150 mg/dl and 813 U/L in the patients who expired respectively.
Conclusion: DKA is a common presentation following an infectious etiology in COVID-19 co morbidity. It can presented with atypical symptoms and divergent outcomes. we suggest that more advances studies with a larger sample size is needed to investigate detailed DKA characteristics, management and outcomes to revise the management protocol of DKA in COVID-19 infection.
Keywords: Diabetic ketoacidosis, COVID-19