1.
J Gen Intern Med
; 38(6): 1547-1551, 2023 05.
Article
in English
| MEDLINE | ID: covidwho-2254490
ABSTRACT
We present the case of a young woman admitted for diabetic ketoacidosis with persistent, asymptomatic lactic acid (LA) elevation during the evolving COVID-19 pandemic. Cognitive biases in interpreting an elevated LA in this patient's care resulted in an extensive infectious workup instead of the low-cost and potentially diagnostic provision of empiric thiamine. We discuss clinical patterns and etiologies of LA elevation and the role of thiamine deficiency. We also address cognitive biases potentially affecting the interpretation of elevated lactate levels and provide guidance for clinicians to determine appropriate patients for empiric thiamine administration.
Subject(s)
Beriberi , COVID-19 , Diabetes Mellitus, Type 1 , Thiamine Deficiency , Female , Humans , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/diagnosis , Pandemics , COVID-19/complications , Thiamine Deficiency/complications , Thiamine Deficiency/diagnosis , Thiamine/therapeutic use , Lactic Acid , Bias , Cognition
2.
J Am Geriatr Soc
; 69(12): 3405-3406, 2021 12.
Article
in English
| MEDLINE | ID: covidwho-1570822