Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or COVID-19, is a pandemic infectious disease involved all over the world. Its mortality, especially in cases with additional co-morbidities, is so high that is has attracted the attention of the world. Diabetes mellitus is known as one of its risk factors for mortality. Case Presentation: A unique case of pediatrics COVID-19 who presented with diabetic ketoacidosis (DKA) is reported in this manuscript as the first presentation. He presented with abdominal pain, nausea, and vomiting. RT-PCR test for COVID-19 via nasal swab was performed, and a positive diagnosis was obtained. Chest CT scan confirmed the diagnosis with multifocal bilateral patchy consolidation. Case was discharged after usual treatment of COVID-19. Conclusion: In pediatrics, this disease can be subtle and have a confusion presentation, but it should be controlled to avoid spread of the disease. During epidemic status, suspicious cases specially children with nonspecific symptoms and other underlying diseases should be considered as at risk or potentially asymptomatic COVID-19 cases.
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