ABSTRACT
Introduction: It is unclear whether diabetes alone contributes to increased risk of morbidity and mortality related to COVID-19. Objective(s): This study aimed to explore the relationship between diabetes and the severity of COVID-19 infection as well as the impact of COVID-19 on the clinical presentation and outcome in patients with type 1 diabetes. Method(s): This cross sectional study included 51 children and adolescents with type 1 diabetes mellitus (T1DM) attending the Pediatric Hospital. Participants included all patients with type 1 diabetes admitted to Children's Hospital, Ain Shams University in the period between August and December 2020. Data of studied patients was extracted from inpatient files and reports. Result(s): The age of the patients ranged from 1-17 years with median of 9 (6-13) years, with female predominance [27 (52.9%)]. A 45 presented in DKA, with mean pH of 7.04 +/- 0.29. The median duration of hospital admission was 4 (2-7) days. A 33 patients were newly diagnosed and presented in DKA except 5 (15.2%) patient that presented in hyperglycemia. The mean HbA1c was 11.70 +/- 1.86, the median time till hospital admission was 1.5 (1-2) days. Acute kidney injury (AKI) and echocardiographic changes were reported in 12 (36.4%) and 4 patients 4 (12.1%) respectively. All patients with AKI were admitted to ICU, all showed significantly lower PH at presentation, HCO3 level, and serum albumin level (p < 0.05). Although 22 patients had COVID infection either by PCR or antibodies, only six patient required respiratory support, 13 patients required circulatory support and 6 had echo changes. Two patients had manifestation of MIS-C and required ICU admission and anticoagulants. Conclusion(s): COVID infection in diabetic patients was associated with sever presentation of DKA and multiple organ affection, which could be related to viral affection or delayed hospital admission during the pandemic.