The impact of COVID-19 on Diabetic Ketoacidosis patients.

Content Provider	Europe PMC
Author	Khan, Faraz Paladino, Lorenzo Sinert, Richard
Copyright Year	2022
Abstract	Background and aimDescribe the prevalence/outcomes of Diabetic Ketoacidosis (DKA) patients comparing pre- (March–April 2019) and pandemic (March–April 2020) periods.MethodsRetrospective cohort of admitted pandemic DKA/COVID-19+ patients comparing prevalence/outcomes to pre-pandemic DKA patients that takes place in Eleven hospitals of New York City Health & Hospitals. Our included participants during the pandemic period were admitted COVID-19+ patients (>18 years) and during the pre-pandemic period were admissions (>18 years) selected through the medical record. We excluded transfers during both periods. The intervention was COVID-19+ by PCR testing. The main outcome measured was mortality during the index hospitalization and secondary outcomes were demographics, medical histories and triage vital signs, and laboratory tests. Definition of DKA: Beta-Hydroxybutyrate (BHBA) (>0.4 mmol/L) and bicarbonate (<15 mmol/L) or pH (<7.3).ResultsDemographics and past medical histories were similar during the pre-pandemic (n = 6938) vs. pandemic (n = 7962) periods. DKA prevalence was greater during pandemic (3.14%, 2.66–3.68) vs. pre-pandemic period (0.72%, 0.54–0.95) (p > 0.001). DKA/COVID-19+ mortality rates were greater (46.3% (38.4–54.3) vs. pre-pandemic period (18%, 8.6–31.4) (p < 0.001). Surviving vs. non-surviving DKA/COVID-19+ patients had more severe DKA with lower bicarbonates by 2.7 mmol/L (1.0–4.5) (p < 0.001) and higher both Anion Gaps by 3.0 mmol/L (0.2–6.3) and BHBA by 2.1 mmol/L (1.2–3.1) (p < 0.001).ConclusionsCOVID-19 increased the prevalence of DKA with higher mortality rates secondary to COVID-19 severity, not DKA. We suggest DKA screening all COVID-19+ patients and prioritizing ICU DKA/COVID-19+ with low oxygen saturation, blood pressures, or renal insufficiency.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8736268&blobtype=pdf
ISSN	18714021
Journal	Diabetes & Metabolic Syndrome [Diabetes Metab Syndr]
Volume Number	16
DOI	10.1016/j.dsx.2022.102389
PubMed Central reference number	PMC8736268
Issue Number	1
PubMed reference number	35016042
e-ISSN	18780334
Language	English
Publisher	Diabetes India. Published by Elsevier Ltd.
Publisher Date	2022-01-07
Access Restriction	Open
Rights License	Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. © 2022 Diabetes India. Published by Elsevier Ltd. All rights reserved.
Subject Keyword	Diabetes Diabetic ketoacidosis dka Covid-19 Coronavirus disease 19 Critical care Infectious disease Emergency medicine
Content Type	Text
Resource Type	Article
Subject	Endocrinology, Diabetes and Metabolism Internal Medicine