Study of clinical features, laboratory and radiological findings, morbidity, and mortality in COVID-19 patients with controlled and uncontrolled diabetes mellitus

Introduction: Coronavirus disease 19 (COVID-19) is a pandemic caused by a novel coronavirus, the Severe Acute Respiratory Syndrome Coronavirus 2. Diabetes and its complications are major causes of morbidity and mortality. Patients with uncontrolled diabetes may be associated with poorer outcomes as compared with patients with good glycemic control. Methodology: A total of 120 patients with type 2 diabetes mellitus with COVID-19 were taken from a tertiary care center in Pune, Maharashtra, and included in the study following their voluntary informed consent. Results: It was observed that patients with poor glycemic control had a greater prevalence of symptoms including fever (64.9% vs 55.4%), cough (51.3% vs 42.2%), and dyspnoea (40.5% vs 27.7%). C-reactive protein (9.40 vs 5.66), D-dimer (668.2 vs 457.9), and ferritin levels (352 vs 238) were observed to be greater in patients with poor glycemic control. Chest X-Ray changes (45.9% vs 17.2%) and CT severity score (9.32 vs 5.79) were significantly greater in patients with poor glycemic control. Patients with poor glycemic control also had an increased incidence of O 2 requirement, increased mortality, and a longer duration of hospital stay. Poor glycemic control was also associated with an increased incidence of complications like acute respiratory distress syndrome (35.1% vs 18.0%), sepsis with or without septic shock (18.9% vs 9.6%), acute coronary syndrome (13.5% vs 8.4%), acute kidney injury (18.9% vs 3.6%), acute hepatic injury (13.5% vs 2.4%), and other complications like diabetic ketoacidosis, pulmonary thromboembolism, and cerebrovascular accident (10.8% vs 6.0%).Conclusion: On the basis of our findings, we concluded that patients with poor glycemic control were associated with poorer outcomes and increased complications. © 2022 Medical Journal of Dr. D.Y. Patil Vidyapeeth ;Published by Wolters Kluwer - Medknow.

Hypertension Secondary to COVID-19 Leading to Posterior Reversible Encephalopathy Syndrome in a 13-year-old Male

Posterior Reversible Encephalopathy Syndrome (PRES) is a clinico-radiological condition defined by white matter vasogenic oedema predominantly affecting the posterior occipital and parietal lobes. A 13-year-old male presented with complaints of fever for 4 days.Upon evaluation, he turned out positive for COVID-19 with a Computed Tomography (CT) severity score of 5/25. Three days post admission (day 7 of illness), patient developed sudden onset of painless, diminution of vision in both eyes followed by two episodes of generalised tonic clonic seizures. Examination revealed a blood pressure of 180/110 mmHg. Characteristic Magnetic Resonance Imaging (MRI) findings led to a diagnosis of PRES. Patient was treated with antiepileptics, antihypertensives and intravenous mannitol and made a complete recovery. Early identification, treatment of symptomatology and correction of the underlying cause are all key aspects of management.