Combined course of acute respiratory coronavirus disease in a child with type 1 diabetes: a clinical case

Abstract

The clinical course of coronavirus disease (COVID-19) in children in combination with diabetes mellitus is characterized by a more pronounced intensity of clinical manifestations and more frequent complications compared to patients without this premorbid condition. For unknown reasons, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) may trigger new-onset diabetes. Over the last decade, the incidence of type 1 diabetes mellitus has increased and the peak age for being diagnosed with type 1 diabetes mellitus is getting younger. This article presents a clinical case of an adolescent female patient with new-onset type 1 diabetes mellitus diagnosed during hospitalization for symptomatic COVID-19 (SARS-CoV-2 was confirmed by polymerase chain reaction of naso/oropharyngeal swabs). The patient felt ill suddenly, her condition was rapidly worsening. She was hospitalized with severe acute respiratory tract infection. The blood work of the patient revealed hyperglycemia, hyperstenuria, glycosuria, ketonuria, hypertransferasemia, elevated levels of glycated hemoglobin and decreased levels of C-peptide. The patient has been receiving fluid replacement treatment intravenously, short-acting insulin to correct hyperglycemia followed by symptomatic treatment therapy. The patient responded well to the treatment plan and was discharged from the hospital after 8 days continuing treatment from home. Conclusions. The presented article describes a clinical case of COVID-19 in adolescent female patient with new-onset type 1 diabetes mellitus. The patient’s severe condition was caused mainly by dehydration and COVID-19 precipitated ketoacidosis despite having light respiratory symptoms. At the moment, it is not enough data to conclude whether type 1 diabetes mellitus in pediatric population can cause serious complications from COVID-19. More studies are required to reach a definitive conclusion. The study was conducted in accordance with the Declaration of Helsinki. Informed consent was obtained from the patient’s parents before the study. No conflict of interests was declared by the authors.