Diabetic ketoacidosis amongst patients with COVID-19: a retrospective chart review of 220 patients in Pakistan
Author(s)
Type
Journal Article
Abstract
Objectives
To determine the frequency of diabetes mellitus and diabetic ketoacidosis and associated factors in COVID-19-positive patients.
Background
High mortality amongst SARS-Cov2 patients may be attributed to diabetes and diabetic ketoacidosis.
Methods
A total of 220 COVID-19 positive patients, hospitalized in North West General Hospital & Research Center, Peshawar, KP, Pakistan, from April to September 2020, were analysed using STATA 14. Patients with positive PCR were labelled as COVID-19 positive and were included in the study. Patients with a clinical picture of COVID-19 and negative PCR were excluded from the study. Those having ketonemia >0.6 and random blood glucose level >250mg/dl, while HCO3 (bicarbonate) ≤18, were labelled as diabetic ketoacidosis. The statistical significance level was set at p < .05.
Results
A total of 220 COVID-19 patients were admitted; 166 (75.4%) were male and 54 (24.5%) were female. The mean age in years of the patients was 55.95 (SD13.9). About 57.7% of patients had diabetes mellitus, and 15 (6.8%) patients developed diabetic ketoacidosis. Amongst those with DKA, 5 patients died during hospital admission. The use of steroids was significantly higher (p < .001) in the DKA group compared with non-DKA patients. Hypertension (103,46.8%) and fever (170,77.3%) were the most reported comorbidity and symptom respectively.
Conclusion
The proportion of diabetes mellitus is high in patients with COVID-19. Diabetic ketoacidosis is a frequent complication in this group associated with in-hospital mortality. Steroid administration for COVID-19 should be balanced with strict glycemic control to prevent diabetic ketoacidosis and increase hospital survival.
To determine the frequency of diabetes mellitus and diabetic ketoacidosis and associated factors in COVID-19-positive patients.
Background
High mortality amongst SARS-Cov2 patients may be attributed to diabetes and diabetic ketoacidosis.
Methods
A total of 220 COVID-19 positive patients, hospitalized in North West General Hospital & Research Center, Peshawar, KP, Pakistan, from April to September 2020, were analysed using STATA 14. Patients with positive PCR were labelled as COVID-19 positive and were included in the study. Patients with a clinical picture of COVID-19 and negative PCR were excluded from the study. Those having ketonemia >0.6 and random blood glucose level >250mg/dl, while HCO3 (bicarbonate) ≤18, were labelled as diabetic ketoacidosis. The statistical significance level was set at p < .05.
Results
A total of 220 COVID-19 patients were admitted; 166 (75.4%) were male and 54 (24.5%) were female. The mean age in years of the patients was 55.95 (SD13.9). About 57.7% of patients had diabetes mellitus, and 15 (6.8%) patients developed diabetic ketoacidosis. Amongst those with DKA, 5 patients died during hospital admission. The use of steroids was significantly higher (p < .001) in the DKA group compared with non-DKA patients. Hypertension (103,46.8%) and fever (170,77.3%) were the most reported comorbidity and symptom respectively.
Conclusion
The proportion of diabetes mellitus is high in patients with COVID-19. Diabetic ketoacidosis is a frequent complication in this group associated with in-hospital mortality. Steroid administration for COVID-19 should be balanced with strict glycemic control to prevent diabetic ketoacidosis and increase hospital survival.
Date Issued
2022-05
Date Acceptance
2022-02-16
Citation
Endocrinology, Diabetes & Metabolism, 2022, 5 (3)
ISSN
2398-9238
Publisher
Wiley
Journal / Book Title
Endocrinology, Diabetes & Metabolism
Volume
5
Issue
3
Copyright Statement
© 2022 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
License URL
Identifier
https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000760598400001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=a2bf6146997ec60c407a63945d4e92bb
Subjects
CORONAVIRUS
COVID-19
diabetes mellitus
diabetic ketoacidosis
Endocrinology & Metabolism
Life Sciences & Biomedicine
Science & Technology
Publication Status
Published
Article Number
e331
Date Publish Online
2022-02-24