COVID-19 Presenting With Diabetic Ketoacidosis: A Case Series

Ramya S Gorthi; Ghassan Kamel; Sandeep Dhindsa; Ravi P Nayak

doi:10.1016/j.aace.2020.11.010

COVID-19 Presenting With Diabetic Ketoacidosis: A Case Series

AACE Clin Case Rep. 2021 Jan-Feb;7(1):6-9. doi: 10.1016/j.aace.2020.11.010. Epub 2020 Dec 28.

Authors

Ramya S Gorthi¹, Ghassan Kamel¹, Sandeep Dhindsa², Ravi P Nayak¹

Affiliations

¹ Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Saint Louis University School of Medicine, Saint Louis, Missouri.
² Division of Endocrinology, Diabetes and Metabolism, Saint Louis University School of Medicine, Saint Louis, Missouri.

Abstract

Objective: Diabetes mellitus has been recognized as one of the comorbidities that predict the severity of illness in patients infected with COVID-19. The characteristics of patients presenting with diabetic ketoacidosis (DKA) and COVID-19 infection have not been described.

Methods: We describe 5 patients with DKA and concomitant COVID-19 admitted to the intensive care unit of an academic medical center. Three patients had type 1 diabetes mellitus, and 2 patients had type 2 diabetes mellitus.

Results: While DKA with an infectious etiology is a common presentation, we observed that the patients with DKA precipitated by COVID-19 presented with atypical symptoms. COVID-19 infection was revealed during search for an etiology of DKA.

Conclusion: It is prudent to have a low threshold to screen for COVID-19 infection in patients with DKA.

Keywords: COVID-19; COVID-19, coronavirus disease-2019; DKA, diabetic ketoacidosis; GI, gastrointestinal; SARS-CoV, severe acute respiratory syndrome coronavirus; SARS-CoV2; SARS-CoV2, Severe Acute Respiratory Syndrome coronavirus 2; T1DM, type 1 diabetes mellitus; T2DM, type 2 diabetes mellitus; diabetic ketoacidosis; type 1 diabetes mellitus; type 2 diabetes mellitus.

Publication types

Case Reports