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DOI: 10.1055/s-0040-1713164
Severe Diabetic Ketoacidosis in a Child with Type-1 Diabetes, Asthma, and COVID-19
Abstract
Little is known about the association between novel coronavirus disease 2019 (COVID-19) and type-1 diabetes in children. A 16-year-old female patient with history of type-1 diabetes was admitted for life threatening diabetic ketoacidosis (DKA). She recovered from the DKA after 24 hours of insulin infusion and rehydration. On day 2, she was diagnosed with COVID-19. The DKA relapsed and required restarting insulin. She developed leukopenia, neutropenia, and high ferritin. Upon recovery, she was discharged for self-quarantine. Severity of DKA in children with COVID-19 is multifactorial. Clinical suspicion of COVID should be heightened in patients who present with unexplainedly severe DKA.
Publication History
Received: 25 April 2020
Accepted: 11 May 2020
Article published online:
10 June 2020
© 2020. Thieme. All rights reserved.
Georg Thieme Verlag KG
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References
- 1 Shen KL, Yang YH. Diagnosis and treatment of 2019 novel coronavirus infection in children: a pressing issue. World J Pediatr 2020; DOI: 10.1007/s12519-020-00344-6.
- 2 Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr 2020; 109 (06) 1088-1095
- 3 CDC COVID-19 Response Team. Coronavirus Disease 2019 in Children - United States, February 12-April 2, 2020. MMWR Morb Mortal Wkly Rep 2020; 69 (14) 422-426
- 4 Hussain A, Bhowmik B, do Vale Moreira NC. COVID-19 and diabetes: Knowledge in progress. Diabetes Res Clin Pract 2020; 162: 108142
- 5 Klonoff DC, Umpierrez GE. COVID-19 in patients with diabetes: risk factors that increase morbidity. Metabolism 2020; DOI: 10.1016/j.metabol.2020.154224.
- 6 McCall B, Nainggolan L. Keep calm: under 25s with diabetes not hospitalized due to COVID-19. Accessed May 18, 2020 at: https://www.medscape.com/viewarticle/927567
- 7 Lu X, Zhang L, Du H. et al. SARS-CoV-2 infection in children. N Engl J Med 2020; DOI: 10.1056/NEJMc2005073.
- 8 Brodin P. Why is COVID-19 so mild in children?. Acta Paediatrica 2020; 109 (06) 1082-1082
- 9 Li LQ, Huang T, Wang YQ. et al. COVID-19 patients' clinical characteristics, discharge rate, and fatality rate of meta-analysis. J Med Virol 2020; DOI: 10.1002/jmv.25757.
- 10 Liu Y, Yan L-M, Wan L. et al. Viral dynamics in mild and severe cases of COVID-19. Lancet Infect Dis 2020; (e-pub ahead of print) DOI: 10.1016/S1473-3099(20)30232–2.
- 11 Ye Q, Wang B, Mao J. The pathogenesis and treatment of the ‘Cytokine Storm’ in COVID-19. J Infect 2020; DOI: 10.1016/j.jinf.2020.03.037.
- 12 Nakamura K, Inokuchi R, Doi K. et al. Septic ketoacidosis. Intern Med 2014; 53 (10) 1071-1073
- 13 Guo W, Li M, Dong Y. et al. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metab Res Rev 2020; DOI: 10.1002/dmrr.3319.