Children's Diabetic Ketoacidosis and COVID 19: Two Case Reports

Abstract

Introduction: The current global pandemic due to SARS-CoV-2 has resulted in a large literature on associated comorbidities, including diabetes. COVID 19 infection in a diabetic child can be complicated by severe ketoacidosis. The aim of this study is to determine the effect of COVID-19 infection on a diabetic child. Observations: The first case involved a 12-year-old Congolese child from a diabetic mother who was hospitalized for febrile respiratory distress and a consciousness disorder. Biological examinations showed the first diabetic ketoacidosis. Chest radiography showed radiological images suggestive of COVID-19 involvement, which was confirmed by a PCR and a thoracic CT. The evolution was marked by the appearance of a left pleurisy of medium abundance, which regressed after treatment. Second, a 16-month-old infant with no prior history was admitted to the hospital for febrile dehydration with impaired consciousness. Biological tests were consistent with diabetic ketoacidosis. Multiplex PCRs were performed showing infection with SARS-CoV-2 and other viruses (adenovirus, rhinovirus and enterovirus). Chest radiography was normal. The evolution was favorable under treatment with insulin therapy, rehydration, and antibiotic therapy. Conclusion: After discussing the role of decompensation or the triggering of diabetes in children with SARS-CoV-2 infection, the authors insist on the polymorphism of the clinical presentation and the need to perform a PCR in a diabetic child with ketoacidosis.