Diabetic ketoacidosis and mortality in COVID-19 infection - 30/11/21
, T.L. Nickolas a, ⁎ , U.B. Pajvani b, ⁎
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Abstract |
Aim |
- Patients with diabetes have increased morbidity and mortality from COVID-19. Case reports describe patients with simultaneous COVID-19 and diabetic acidosis (DKA), however there is limited data on the prevalence, predictors and outcomes of DKA in these patients.
Methods |
- Patients with COVID-19 were identified from the electronic medical record. DKA was defined by standardized criteria. Proportional hazard regression models were used to determine risk factors for, and mortality from DKA in COVID-19.
Results |
- Of 2366 patients admitted for COVID-19, 157 (6.6%) patients developed DKA, 94% of whom had antecedent type 2 diabetes, 0.6% had antecedent type 1 diabetes, and 5.7% patients had no prior diagnosis of diabetes. Patients with DKA had increased hospital length of stay and in-patient mortality. Higher HbA1c predicted increased risk of incident DKA (HR 1.47 per 1% increase, 95% CI 1.40–1.54). Risk factors for mortality included older age (HR 1.07 per 5 years, 95% CI 1.06–1.08) and need for pressors (HR 2.33, 95% CI 1.82–2.98). Glucocorticoid use was protective in patients with and without DKA.
Conclusion |
- The combination of DKA and COVID-19 is associated with greater mortality, driven by older age and COVID-19 severity.
Le texte complet de cet article est disponible en PDF.Keywords : Coronavirus, COVID-19, Diabetic ketoacidosis, DKA, SARS-CoV-2
Plan
Vol 47 - N° 6
Article 101267- novembre 2021 Retour au numéro
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