COVID-19 Related Predisposition to Diabetic Ketoacidosis

Area of Science:

• Endocrinology
• Infectious Diseases
• Critical Care Medicine

Background:

• Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can worsen hyperglycemia in diabetes mellitus (DM).
• Diabetic ketoacidosis (DKA) is a life-threatening complication that can arise in diabetic patients with COVID-19.

Purpose of the Study:

• To compare characteristics of diabetic COVID-19 patients with and without DKA.
• To identify predictors of mortality in diabetic COVID-19 patients with DKA.

Main Methods:

• Retrospective single-center cohort study of 301 patients with COVID-19 and DM (March 2020 - June 2020).
• Patients were categorized into DKA and non-DKA/hyperosmolar hyperglycemic state (HHS) groups.
• Mortality and its predictors were analyzed using logistic regression.

Main Results:

• 10% of patients developed DKA; 1.7% had HHS.
• Mortality was higher in the DKA group (36.6%) versus non-DKA/HHS group (19.5%).
• Independent mortality predictors included age, platelet count, creatinine, C-reactive protein, hypoxic respiratory failure, intubation, and vasopressor use.

Conclusions:

• Diabetic COVID-19 patients with DKA exhibited a higher mortality rate.
• DKA was not an independent predictor of mortality in the multivariate model.
• Vigilant risk stratification and timely management are crucial for these high-risk patients.