Mortality higher for diabetic ketoacidosis with COVID-19

(HealthDay)—Patients with diabetic ketoacidosis (DKA) with COVID-19 have a much higher rate of mortality than patients without COVID-19, according to a research letter published online March 10 in JAMA Network Open.

Francisco J. Pasquel, M.D., from the Emory University School of Medicine in Atlanta, and colleagues used individual-level inpatient data from 175 U.S. hospitals (17 states; Feb. 1 to Sept. 15, 2020) to examine severity markers of DKA, insulin requirements, complications, and in-hospital case fatality in 5,029 patients treated with the same computerized continuous insulin infusion (CII) algorithm with and without COVID-19.

The researchers found that 4 percent of patients (210 patients) were positive for COVID-19. Those with COVID-19 were older and had a higher body mass index compared with patients without COVID-19. Older patients with COVID-19 (>65 years) were more likely to have cardiovascular disease and diabetes complications than younger patients with COVID-19 (<45 years). Higher insulin requirements and a prolonged duration of CII with a longer time to resolution of DKA were seen among patients with COVID-19. Five percent of patients without COVID-19 died in the hospital versus 30 percent among those with COVID-19. Acute kidney injury was more frequent in patients with COVID-19 versus those without (30 versus 10 percent).

“These findings are worrisome and warrant further investigation,” the authors write.

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