ABSTRACT
Background: Coronavirus disease 2019 (COVID-19) has spread quickly. Comorbidities, such as diabetes, have been determined as critical risk factors for COVID-19. Objective(s): This study aimed to determine the frequency and severity of diabetic ketoacidosis (DKA) in children before and during the COVID-19 pandemic. Method(s): This retrospective study examined children aged less than 18 years diagnosed with DKA hospitalized in Yazd Shahid Sadoughi Hospital from February 20, 2020, to November 21, 2021. The collected information was compared to those obtained during the same period in 2019 (pre-pandemic). According to the inclusion criteria, only children with suspected symptoms of COVID-19 or an infected family member underwent PCR. Result(s): The study included 70 children with confirmed DKA during the COVID-19 pandemic and 33 children hospitalized during the pre-pandemic period. The findings showed that the rate of DKA was higher during the pandemic than in the pre-pandemic period. In the DKA subgroups (during the COVID-19 pandemic vs. pre-pandemic), 35.7% vs. 21.2% were severe, 37.1% vs. 36.4% were moderate, and 27.1% vs. 42.4% were mild. Of 70 children, 30 underwent PCR tests for COVID-19, showing six positive cases. Among positive cases, five had mild symptoms, while one was hospitalized with signs of respiratory distress, polyuria, and polydipsia. All physical examinations of this patient were normal, except for the chest exam. Conclusion(s): A remarkable increase was observed in the frequency and severity of DKA in children during the pandemic.Copyright © 2023, International Journal of Endocrinology and Metabolism. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
ABSTRACT
Background: Mild symptoms of COVID-19 in children may lead to delayed or misdiagnosis. Reverse transcription polymerase chain reaction (RT-PCR) is an approved laboratory method for detecting COVID-19 virus. Given that COVID-19 is considered an emerging disease, its diagnostic methods in children have not yet been well compared. Therefore, this study was designed to compare RT-PCR, lung CT scan, and anti-COVID-19 antibody results in hospitalized children suspected for COVID-19. Methods: This cross-sectional study was conducted on patients less than 18 years of age, suspected fot COVID-19, and admitted to Shahid Sadoughi Hospital in Yazd, Iran, from February 2020 to February 2021. All hospitalized children who had suspected COVID-19 based on their initial clinical symptoms or signs, and had undergone RT-PCR were included in the study. Demographic data such as age, sex, contact history with COVID-19 patients, clinical manifestations, outcome, comorbidities, and information on other paraclinical procedures were collected by checklist. Results: In total, 53.3% of the patients were male, and 59% were under five years old. The most common symptom was fever (81%), followed by respiratory distress (34.3%) and diarrhea (26.7%), and cough (19%). Additionally, a significant relationship was observed between respiratory symptoms and a positive PCR test (P = 0.020) and positive lung CT findings (P = 0.017). This study failed to find a significant association between PCR, chest CT scan, and anti-COVID-19 antibody results with ICU admission, endotracheal intubation, and death (P>0.05). Conclusions: Our findings showed a significant association between respiratory symptoms, positive RT- PCR, and positive CT findings. But ICU admission, endotracheal intubation, and death were not significantly correlated with PCR, chest CT scan, and anti-COVID-19 antibodies.