Clinical Characteristics and Outcome in Patients with Combined Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State Associated with COVID-19: A Retrospective, Hospital-Based Observational Case Series
AIM: One of the risk factors for poor outcome with SARS-CoV-2 infection is diabetes mellitus; diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are the most serious complications of diabetes mellitus. We aimed to explore the clinical characteristics and outcomes of COVID-19 patients presenting with combined DKA/HHS to our institution.
METHODS: A retrospective, hospital based observation case series was performed on patients with SARS-CoV-2 admitted to Intensive Care Unit between 3/20/2020 and 4/20/2020. Inclusion criteria were: (1) Blood Glucose >250 mg/dL; (2) Serum bicarbonate/L; (3) Anion Gap >10; (4) serum pH304 mOsm/kg and (7) positive SARS-CoV-2 RT-PCR.
RESULTS: We reported 6 patients who presented during this period with combined DKA/HHS. Their median age was 50 years, all males, three Hispanic, and three African American. Hispanic patients, had more severe acidosis, and multiple comorbidities, with a higher mortality. The striking feature was that combined DKA/HHS was the initial presentation for COVID-19 for most of the cases.
DISCUSSION: Our observational retrospective case series shows that diabetic patients are at risk of developing combined DKA/ HHS associated with COVID-19 and a substantial mortality. To our knowledge, we are first to report the clinical characteristics and outcome in this group of patients.
Chan, K., Thimmareddygari, D., Ramahi, A., Atallah, L., Baranetsky, N. G., & Slim, J. (2020). Clinical Characteristics and Outcome in Patients with Combined Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State Associated with COVID-19: A Retrospective, Hospital-Based Observational Case Series. Diabetes Research and Clinical Practice, 166, 108279-108279. https://doi.org/10.1016/j.diabres.2020.108279