Bilateral renal infarction in a patient with severe COVID-19 infection

Herrera-Añazco, Percy; Balta, Fernando Mayor; Córdova-Cueva, Liz

doi:10.1590/2175-8239-jbn-2020-0156

Cited by 14 publications

(12 citation statements)

References 22 publications

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“…Among the included studies, 11 reported DKA and COVID-19 in children [ 8 , 11 , 22 , 30 , 34 , 44 , 45 , 56 , 61 , 66 , 72 ], 56 reported DKA and COVID-19 in adults [ 9 , 10 , 12 – 21 , 23 , 25 – 29 , 31 – 33 , 35 – 43 , 46 – 55 , 57 – 60 , 62 – 65 , 67 – 71 , 73 – 75 ], and only 1 study reported DKA and COVID-19 in both children and adults [ 24 ]. There were 54 case report [ 8 – 12 , 14 , 16 , 17 , 19 – 23 , 25 – 27 , 29 – 42 , 44 – 51 , 53 – 58 , 60 , 61 , 64 , 66 , 67 , 69 , 71 , 72 , 74 , 75 ], 10 case series [ 13 , 15 , 28 , 43 , 58 , 59 , 62 , 63 , 70 , 73 ...…”

Section: Resultsmentioning

confidence: 99%

“…The median or mean patient age ranged from < 1 years to 66 years across studies. There was an increased male predominance in DKA patients diagnosed with SARS-CoV-2 in most of the studies [n = 373, 58.4%] [ 9 – 13 , 15 – 17 , 19 , 20 , 23 , 25 , 26 , 31 – 33 , 36 , 37 , 39 , 45 , 47 , 50 – 52 , 55 – 58 , 60 – 64 , 67 – 69 , 74 , 75 ] and majority of the patients belonged to Hispanic (n = 156, 24.4%) and black (n = 98, 15.3%) ethnicity [ 14 – 16 , 18 , 19 , 21 , 24 , 27 , 28 , 44 – 46 , 54 , 57 , 58 , 62 , 63 , 65 , 68 , 75 ]. The median BMI for all included patients was 27.3 kg/m 2 [interquartile range (IQR) 24.8–30.6 kg/m 2 ].…”

Section: Resultsmentioning

confidence: 99%

“…The current meta-analysis is more comprehensive and included a total of 68 studies [ 8 – 75 ] including a total of 639 patients; whose details on final treatment outcome were available; in comparison to smaller sample size in previous meta-analyses [sample size: n = 45 and n = 21, respectively] [ 90 , 91 ]. The inclusion of 48 recently published studies [ 8 – 14 , 16 , 21 , 23 – 26 , 28 , 30 , 32 – 35 , 40 , 42 – 46 , 48 , 50 , 51 , 53 , 54 , 56 – 59 , 61 – 64 , 66 – 75 ] contributed to the refinement on evidence of the demographic, biochemical, and clinical characteristics; in addition to final therapy outcome in COVID-19 patients with DKA.…”

Section: Discussionmentioning

confidence: 99%

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Diabetic ketoacidosis in patients with SARS-CoV-2: a systematic review and meta-analysis

Alhumaid

Mutair

Alawi

et al. 2021

Diabetol Metab Syndr

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Background One possible reason for increased mortality due to SARS-CoV-2 in patients with diabetes is from the complication of diabetic ketoacidosis (DKA). Objectives To re-evaluate the association of SARS-CoV-2 and development of DKA and analyse the demographic and biochemical parameters and the clinical outcomes in COVID-19 patients with DKA. Design A systematic review and meta-analysis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was followed. Methods Electronic databases (Proquest, Medline, Embase, Pubmed, CINAHL, Wiley online library, Scopus and Nature) were searched from 1 December 2019 to 30 June 2021 in the English language using the following keywords alone or in combination: COVID-19 OR SARS-CoV-2 AND diabetic ketoacidosis OR DKA OR ketosis OR ketonemia OR hyperglycaemic emergency OR hyperglycaemic crisis. We included studies in adults and children of all ages in all healthcare settings. Binary logistic regression model was used to explore the effect of various demographic and biochemical parameters variables on patient’s final treatment outcome (survival or death). Results Of the 484 papers that were identified, 68 articles were included in the systematic review and meta-analysis (54 case report, 10 case series, and 4 cohort studies). Studies involving 639 DKA patients with confirmed SARS-CoV-2 [46 (7.2%) were children and 334 (52.3%) were adults] were analyzed. The median or mean patient age ranged from < 1 years to 66 years across studies. Most of the patients (n = 309, 48.3%) had pre-existing type 2 diabetes mellitus. The majority of the patients were male (n = 373, 58.4%) and belonged to Hispanic (n = 156, 24.4%) and black (n = 98, 15.3%) ethnicity. The median random blood glucose level, HbA1c, pH, bicarbonate, and anion gap in all included patients at presentation were 507 mg/dl [IQR 399–638 mg/dl], 11.4% [IQR 9.9–13.5%], 7.16 [IQR 7.00–7.22], 10 mmol/l [IQR 6.9–13 mmol/l], and 24.5 mEq/l [18–29.2 mEq/l]; respectively. Mortality rate was [63/243, 25.9%], with a majority of death in patients of Hispanic ethnicity (n = 17, 27%; p = 0.001). The odd ratios of death were significantly high in patients with pre-existing diabetes mellitus type 2 [OR 5.24, 95% CI 2.07–15.19; p = 0.001], old age (≥ 60 years) [OR 3.29, 95% CI 1.38–7.91; p = 0.007], and male gender [OR 2.61, 95% CI 1.37–5.17; p = 0.004] compared to those who survived. Conclusion DKA is not uncommon in SARS-CoV-2 patients with diabetes mellitus and results in a mortality rate of 25.9%. Mortality key determinants in DKA patients with SARS-CoV-2 infection are individuals with pre-existing diabetes mellitus type 2, older age [≥ 60 years old], male gender, BMI ≥ 30, blood glucose level > 1000 mg/dl, and anion gap ≥ 30 mEq/l.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Diabetic ketoacidosis in patients with SARS-CoV-2: a systematic review and meta-analysis

Alhumaid

Mutair

Alawi

et al. 2021

Diabetol Metab Syndr

View full text Add to dashboard Cite

show abstract

“…Nevertheless, the cause of renal infarction could not be identified in around 30% of the reported cases. 12 Most patients with renal infarction present with abdominal or flank pain; thus, renal infarction may be misdiagnosed initially as acute renal colic or acute pyelonephritis. 1 In a retrospective study of 14 patients, renal infarction was initially misdiagnosed as renal colic.…”

Section: Discussionmentioning

confidence: 99%

“…Renal infarction was also reported on rare occasions in association with other disorders, including but not limited to aortic dissection, vasculitis, systemic lupus erythematosus (SLE), septic emboli due to infective endocarditis, sickle cell diseases, and renal arteries fibromuscular dysplasia (FMD). Nevertheless, the cause of renal infarction could not be identified in around 30% of the reported cases 12 . Most patients with renal infarction present with abdominal or flank pain; thus, renal infarction may be misdiagnosed initially as acute renal colic or acute pyelonephritis 1 .…”

Section: Discussionmentioning

confidence: 99%