Diabetic ketoacidosis and mortality in COVID-19 infection.
Diabetes Metab
; 47(6): 101267, 2021 11.
Article
in English
| MEDLINE | ID: covidwho-1330743
ABSTRACT
AIM:
- Patients with diabetes have increased morbidity and mortality from COVID-19. Case reports describe patients with simultaneous COVID-19 and diabetic acidosis (DKA), however there is limited data on the prevalence, predictors and outcomes of DKA in these patients.METHODS:
- Patients with COVID-19 were identified from the electronic medical record. DKA was defined by standardized criteria. Proportional hazard regression models were used to determine risk factors for, and mortality from DKA in COVID-19.RESULTS:
- Of 2366 patients admitted for COVID-19, 157 (6.6%) patients developed DKA, 94% of whom had antecedent type 2 diabetes, 0.6% had antecedent type 1 diabetes, and 5.7% patients had no prior diagnosis of diabetes. Patients with DKA had increased hospital length of stay and in-patient mortality. Higher HbA1c predicted increased risk of incident DKA (HR 1.47 per 1% increase, 95% CI 1.40-1.54). Risk factors for mortality included older age (HR 1.07 per 5 years, 95% CI 1.06-1.08) and need for pressors (HR 2.33, 95% CI 1.82-2.98). Glucocorticoid use was protective in patients with and without DKA.CONCLUSION:
- The combination of DKA and COVID-19 is associated with greater mortality, driven by older age and COVID-19 severity.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Diabetic Ketoacidosis
/
COVID-19
Type of study:
Observational study
/
Prognostic study
Limits:
Aged
/
Humans
Language:
English
Journal:
Diabetes Metab
Journal subject:
Endocrinology
/
Metabolism
Year:
2021
Document Type:
Article
Affiliation country:
J.diabet.2021.101267
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