Diabetic ketoacidosis and mortality in COVID-19 infection - 28/07/21
, 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.Key Words : Coronavirus, COVID-19, Diabetic ketoacidosis, DKA, SARS-CoV-2
Plan
| Author Contribution: JSS: study conceptualization and design; data acquisition, analysis and interpretation; writing and editing |
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| MMB: study conceptualization and design; data acquisition, analysis and interpretation; writing and editing |
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| DJM: data management, analysis and interpretation; writing and editing |
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| JZ: data acquisition |
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| PK: conceptualization, methodology, writing and editing |
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| SM: data acquisition, writing and editing |
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| MTY: study conceptualization and design; data analysis and interpretation; writing and editing |
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| TLN: study conceptualization and design; data analysis and interpretation; writing and editing |
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| UP: study conceptualization and design; data analysis and interpretation; writing and editing |
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