IDF21-0273 New-Onset Diabetic Ketoacidosis as a first manifestation of Covid-19 at emergency department

Abstract

Background: The increased prevalence of Ketoacidosis Diabetes (DKA) nowadays could be partly related to delayed hospital admission or the effect of COVID-19 in exacerbating and/or triggering DKA, possesses a real challenge in managing patients; requiring special considerations and management protocols. Aim: We aimed to evaluate patients admitted to our emergency department with new onset DKA who had a COVID-19 infection. Method: We presented four cases admitted to the hospital with newly diagnosed DKA associated with COVID-19. We also reviewed almost all published cases of DKA that had been precipitated by COVID-19. Results: A total of 4 of the patients with newly diagnosed and SARS-CoV-2 PCR positive. The mean age was 40.5 years old ± 16.5. The average time duration between the onset of symptoms of DKA to admission was 2 days. The most common symptoms were asthenia (50%) and digestive symptoms (25%). All patients had a Glasgow Coma Score below 15 and 3 patients had severe DKA. Concerning the biochemical characteristics, the median pH was 6.97 ± 0.17, HCO3- 5.7 ± 1.4 mmol/l and PCO2 28.6 ±10.5 mmHg. The outcome was favorable in 3 patients. Discussion: The link between COVID-19 and diabetes remains controversial and whether diabetes itself indeed increases the susceptibility of infection or COVID-19 infection alters the subsequent risk of new-onset diabetes remains the main question. Efforts should be done to continuously raise awareness about diabetes as well as the importance of seeking timely medical guidance.