COVID-19 Pneumonia, Diabetes and Alteration of the Biochemical Values of Blood: A Case Report and Review of the Literature

Abstract

Aims: The variability in evolution of the novel coronavirus has perplexed the medical community. We herein report the case of a patient with specific characteristics, somewhat outside the reported average values.
 Presentation of Case: A 60-year-old type I diabetic patient was admitted as an outpatient to a university hospital for the following symptoms: fever up to 38.1˚C, malaise, and shortness of breath. Upon admittance, the chest X-ray revealed a homogenous triangular opacity, of medium intensity, located in the lower lobe of the left lung, suggesting pneumonia. Altered biochemistry values in our hospital included ALT = 86U/L, AST = 118 U/L, serum urea = 43.4 mg/dL, serum creatinine = 1.43 mg/dL, fasting blood glucose = 167.9 mg/dL (she had type 1 diabetes and received insulin only in the evening), triglycerides = 214.9 mg/dL, serum magnesium = 1.48 mg/dL, serum iron = 14.1 mg/dL. Fever, malaise, and shortness of breath, together with the X-ray image of the chest suggested COVID-19. RT-PCR confirmed the diagnosis 12 hours later. Three days after admission, she felt dyspneic, and oxygen therapy was administered for 7 days, together with Lopinavir/Ritonavir, Dexamethasone, Heparin and Vitamin C. After 18 days in the hospital, she felt good, and was released from the hospital.
 Conclusion: Despite the numerous aggravating factors for COVID-19 (age [60 years old], type 1 diabetes, increased values of ALT, AST, serum urea, serum creatinine, fasting blood glucose, low serum magnesium, one whole lobe pneumonia, and only one favorable factor–low serum iron), the patient survived and recovered.