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Medical Science Monitor Basic Research


COVID-19-Induced Diabetic Ketoacidosis and Acute Respiratory Distress Syndrome in an Obese 24-Year-Old Type I Diabetic

Educational Purpose (only if useful for a systematic review or synthesis), Rare co-existance of disease or pathology

Sukhdev Singh, Allison Foster, Zohaib Khan, Aisha Siddiqui, Muhammed Atere, Jay M. Nfonoyim

USA College of Medicine, American University of Antigua, New York City, NY, USA

Am J Case Rep 2020; 21:e925586

DOI: 10.12659/AJCR.925586

Available online: 2020-10-19

Published: 2020-10-26


BACKGROUND: In early 2020, severe acute respiratory syndrome-corona virus 2 caused an outbreak of a viral pneumonia that rapidly progressed to a global pandemic. Most cases presented with mild respiratory symptoms and required only supportive care with instructions to self-quarantine at home. Others had more severe symptoms that became complicated by acute respiratory distress syndrome (ARDS) and required hospitalization.
CASE REPORT: In this report, we present the case of a young patient in New York City who presented to our hospital with coronavirus disease 2019-induced diabetic ketoacidosis (DKA) that progressed to ARDS and subsequent death. The patient was managed for DKA on presentation with insulin protocol and acidosis management. However, it became evident that he had underlying respiratory complications, which later presented as ARDS requiring mechanical ventilation and antibiotics.
CONCLUSIONS: We recommend that clinicians be aware of this potentially fatal complication in all patients with pre-existing diabetes. Simultaneously, a low threshold for intubation should be advocated for patients with concurrent COVID-19 and type I diabetes mellitus since the potential for poor clinical outcomes from respiratory demise may be lessened by early respiratory intervention.

Keywords: COVID-19, Diabetes Mellitus, Type 1, Diabetic Ketoacidosis, Respiratory Distress Syndrome, Adult, SARS Virus