ABSTRACT
RATIONALE: New York City (NYC) was an epicenter of the coronavirus disease 2019 (COVID-19) outbreak in the United States during the spring of 2020 with approximately 203,000 laboratory-confirmed cases reported from March to May of 2020. Jamaica Hospital Medical Center (JHMC) and Flushing Hospital Medical Center (FHMC) are both located in Queens, New York, one of the NYC boroughs with the largest number of COVID-19 cases. While managing COVID-19 patients, we observed an increased prevalence of severe hyperglycemia and DKA in COVID-19 patients with increased insulin requirements. We conducted a study to compare the prevalence of DKA, insulin requirements, and time to resolution of DKA from March 15 to May 15 of 2019 to the same period in 2020. This study will help us better manage these patients during this ongoing pandemic. METHODS: This retrospective study included patients aged 18 years and older hospitalized for DKA at JHMC & FHMC between March 15th and May 15th of 2019 and 2020. We looked at age, sex, serum glucose, serum betahydroxybutyrate, steroid use, subcutaneous insulin requirements, time to resolution of DKA, etc., along with clinical notes. Our study was appropriately powered to find a 10 unit increase in daily subcutaneous insulin requirement. The statistical analysis was performed with SPSS version 19.0. Normalcy was assessed with the Shapiro-Wilk test. Statistical significance was assessed with the Mann-Whitney U Test. RESULTS: The number of DKA cases was 27 in 2019 versus 76 in 2020. Out of those 76 cases, 52 of them were COVID-19 positive. There was an increased use of steroids in patients with COVID-19 and DKA compared to the non-COVID-19 patients with DKA. Despite this, there was no statistically significant difference in time to resolution of DKA or insulin requirements in patients with COVID-19 and DKA identified in our study. CONCLUSION: COVID-19 is associated with an increased prevalence of DKA. There is no difference in time to resolution of DKA or insulin requirements in patients with DKA and COVID-19 compared to patients without COVID-19 identified in our study.