Diabetic emergencies presenting during the COVID‐19 pandemic: A retrospective case analysis. Issue 1 (29th October 2021) - Joseph, Tobin
Abstract: Introduction: COVID‐19 has triggered a global pandemic and is an emerging situation. Diabetes has been associated with significant mortality in SARS and MERS‐COV infections. Patients with diabetes are at risk of COVID‐19 triggering diabetic emergencies due to known and unknown mechanisms. There is little evidence overviewing the clinical course of COVID‐19 patients who either present or have diabetic emergencies during their disease course. Methods: We conducted a retrospective case analysis of all patients admitted to our hospital during the COVID‐19 pandemic. The inclusion criteria were all patients receiving treatment for COVID‐19 and either presenting with a diabetic emergency on admission or developing an emergency during their admission. Data collected for the study were all routinely collected data as part of the admission. We compared these data to nine patients with no COVID‐19. Results: Thirty patients received treatment for a diabetic emergency, of which 21 also received treatment for COVID‐19. Significant differences were found between pH and bicarbonate on admission between RT‐PCR‐positive and both RT‐PCR‐negative and non‐COVID‐19 patients. Other results approaching significance include ALP and eGFR. Discussion: Patients suffering from COVID‐19 and diabetes concurrently can suffer from profound metabolic disturbance, with a significant difference in inpatient mortality. However further, prospective detailed investigation into biochemical processes is needed to fully elucidate underlying mechanisms that affect these patients' outcomes. Abstract : This is the first study to investigate diabetic emergencies in the inpatient setting during the first wave of the COVID‐19 pandemic. We demonstrate a mortality difference in patients with diabetes, and highlight the importance of careful observation of patients suffering from both COVID‐19 and a diabetic emergency.