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Diabetic ketoacidosis and COVID-19: what have we learned so far?

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AMER PHYSIOLOGICAL SOC
DOI: 10.1152/ajpendo.00244.2021

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COVID-19; diabetic ketoacidosis; diabetes mellitus; SARS-CoV-2

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There is a clear correlation between COVID-19 and diabetic ketoacidosis (DKA). SARS-CoV-2 infection can precipitate hyperglycemia and ketoacidosis in both diabetic and nondiabetic patients, leading to severe outcomes. DKA in COVID-19 patients may increase risk and worsen outcomes, emphasizing the need for rapid interventions to minimize complications and spreading.
In December 2019, a pandemic emerged due to a new coronavirus that imposed various uncertainties and discoveries. It has been reported that diabetes is a risk factor for worst outcomes of COVID-19 and also that SARS-CoV-2 infection was correlated with the occurrence of diabetic ketoacidosis (DKA) in patients. The aim of this work is to discuss this correlation emphasizing the main case reports from 2020 while exploring the management of DKA during the course of COVID-19. Web of Science, PubMed, and Scopus databases were searched using two sets of Medical Subject Heading (MeSH) search terms or Title/ Ketoacidosis (Diabetic Ketoacidosis, Diabetic Acidosis, Diabetic Ketosis). There is a clear correlation between COVID-19 and DKA. The SARS-Cov-2 infection may precipitate both a hyperglycemic state and ketoacidosis occurrence in patients with diabetes and nondiabetic patients, which may lead to fatal outcomes. DKA in patients with COVID-19 may increase risk and worse outcomes. Hence, the SARS-Cov-2 infection presents a new perspective toward the management of glycemia and acidosis in patients with diabetes and nondiabetic patients, highlighting the need for rapid interventions to minimize the complications from COVID-19 while reducing its spreading.

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