COVID-19 in a Child With Diabetic Ketoacidosis: An Instigator, a Deviator or a Spectator

Daniel, S; Gadhiya, Bhushit; Parikh, Akanksha; Joshi, Preetha

doi:10.1007/s13312-020-2008-2

Cited by 6 publications

(3 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Following removal of duplicates and the exclusions, 20 studies were eligible for the systematic review (Figure 1). [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] Seven of the studies were conducted in Europe, five in USA, four in North Africa, and four in Asia (Table 1). In terms of design, two studies were case series and 18 were case reports In total, there were 37 cases of new onset T1D.…”

Section: Resultsmentioning

confidence: 99%

COVID-19 induced type 1 diabetes: A systematic review of case reports and series

Stathi,

Triantafyllidis,

Zafeiri

et al. 2023

J Int Med Res

View full text Add to dashboard Cite

Aims To provide an overview of reported cases of new-onset type 1 diabetes mellitus (T1D) following COVID-19 infection. Methods PubMed and Scopus library databases were screened for relevant case reports published between January 2020 and June 2022. Study design, geographic region or language were not restricted. Results Twenty studies were identified and involved 37 patients (20 [54%] male, 17 [46%] female). Median age was 11.5 years (range 8 months–33 years) and 31 (84%) patients were aged ≤17 years. Most patients (33, 89%) presented with diabetic ketoacidosis (DKA). In total, 23 (62%) patients presented at the time of positive COVID-19 testing and 14 (38%) had symptoms consistent with COVID-19 infection or a previous positive test (1–56 days). Diabetes symptomatology was provided in 22 cases and (19, 86%) reported polyuria, polydipsia, polyphagia, fatigue, or weight loss or a combination of the aforementioned in the preceding weeks (3 days–12 weeks). Of the 28 patients that had data on acute and long-term treatment, all recovered well and most were managed with basal bolus insulin regimens. Quality assessment showed that most reports were either ‘good’ or ‘moderate quality’. Conclusions Although uncommon, new-onset T1D is a condition healthcare professionals may expect to see following a COVID-19 infection.

show abstract

Section: Resultsmentioning

confidence: 99%

COVID-19 induced type 1 diabetes: A systematic review of case reports and series

Stathi,

Triantafyllidis,

Zafeiri

et al. 2023

J Int Med Res

View full text Add to dashboard Cite

show abstract

“…The detailed characteristics of the included studies are shown in Table 1 . 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 , …”

Section: Resultsmentioning

confidence: 99%

“…In our study, out of the 639 DKA patients infected with SARS-CoV-2, there was (n = 75, 11.7%) newly diagnosed diabetes mellitus cases at admission. Of these 75 cases, 22 had HbA1c > 9.0% (ranging from 9.5% to 17.4%) [ 8 , 9 , 11 , 12 , 20 , 22 , 33 – 35 , 39 , 40 , 44 , 45 , 53 , 56 , 67 , 69 ] and three of which had a BMI > 30 [ 44 , 69 ], suggesting these patients had undiagnosed diabetes mellitus and improbable was caused by SARS-CoV-2 infection. DKA in COVID-19 patients was the least to occur in newly diagnosed diabetes cases probably as a result of increased diabetes screening and early recognition, DKA now occurs more frequently in persons with established diabetes rather than at the time of the initial diagnosis [ 100 ].…”

Section: Discussionmentioning

confidence: 99%

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

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.

show abstract

Clinical profile and outcomes in COVID-19 patients with diabetic ketoacidosis: A systematic review of literature

Pal

Banerjee

Yadav

et al. 2020

Diabetes & Metabolic Syndrome: Clinical Research & Revi

View full text Add to dashboard Cite

Background and aim To conduct a systematic literature review and analyze the demographic/biochemical parameters and clinical outcomes of COVID-19 patients with diabetic ketoacidosis (DKA) and combined DKA/HHS (hyperglycemic hyperosmolar syndrome). Methods PubMed, Scopus, Embase, and Google Scholar databases were systematically searched till August 3, 2020 to identify studies reporting COVID-19 patients with DKA and combined DKA/HHS. A total of 19 articles reporting 110 patients met the eligibility criteria. Results Of the 110 patients, 91 (83%) patients had isolated DKA while 19 (17%) had DKA/HHS. The majority of the patients were male (63%) and belonged to black ethnicity (36%). The median age at presentation ranged from 45.5 to 59.0 years. Most of the patients (77%) had pre-existing type 2 diabetes mellitus. Only 10% of the patients had newly diagnosed diabetes mellitus. The median blood glucose at presentation ranged from 486.0 to 568.5 mg/dl, being higher in patients with DKA/HHS compared to isolated DKA. The volume of fluid replaced in the first 24 h was higher in patients with DKA/HHS in contrast to patients with DKA alone. The in-hospital mortality rate was 45%, with higher mortality in the DKA/HHS group than in the isolated DKA group (67% vs. 29%). pH was lower in patients who had died compared to those who were discharged. Conclusion DKA in COVID-19 patients portends a poor prognosis with a mortality rate approaching 50%. Differentiating isolated DKA from combined DKA/HHS is essential as the latter represents nearly one-fifth of the DKA cases and tends to have higher mortality than DKA alone.

show abstract

COVID-19 in a Child With Diabetic Ketoacidosis: An Instigator, a Deviator or a Spectator

Cited by 6 publications

References 5 publications

COVID-19 induced type 1 diabetes: A systematic review of case reports and series

COVID-19 induced type 1 diabetes: A systematic review of case reports and series

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

Clinical profile and outcomes in COVID-19 patients with diabetic ketoacidosis: A systematic review of literature

Contact Info

Product

Resources

About