Analysis of clinical characteristics of diabetic ketoacidosis complicated with coronavirus disease 2019

doi:10.11958/20230432

Abstract

Abstract:

Objective To explore the clinical features of diabetic ketoacidosis (DKA) complicated with COVID-19. Methods DKA patients were divided into two groups, with 29 cases in the DKA group and 36 cases in the DKA+COVID-19 group. The general data of patients were collected. The serum uric acid, creatinine, white blood cell count, lymphocyte count, hemoglobin, blood glucose at first diagnosis, glycosylated hemoglobin A1c (HbA1c), β-hydroxybutyrate, bicarbonate (HCO3-), arterial blood pH, fasting blood glucose (FBG), 2 h postprandial blood glucose (PBG2 h), fasting C-peptide, 2 h postprandial C-peptide and other laboratory indexes were detected in two groups. The insulin dosage was calculated when blood glucose reached the standard during hospitalization. Results There were no significant differences in blood pressure, gender, body mass index (BMI), uric acid, creatinine, hemoglobin, FBG and PBG2 h between two groups (P>0.05). Compared with the DKA group, patients in the DKA+COVID-19 group were older and had longer course of disease (P<0.05). The white blood cell count, blood glucose at first diagnosis, β-hydroxybutyrate, CK, CK-MB, HbA1c and insulin use were increased, fasting C-peptide, 2 h postprandial C-peptide, PH and lymphocyte count were decreased in the DKA+COVID-19 group (P<0.05). Conclusion Patients with DKA combined with COVID-19 have more severe metabolic disorder and infection at onset, worse immunity, worse islet cell function and higher insulin use.

Key words: diabetes mellitus, type 2, diabetic ketoacidosis, COVID-19, insulin, disease attributes

CLC Number:

R587.2

Figures/Tables 4

References 18

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组别	n	性别（男/女）	年龄/岁	病程/年	BMI/（kg/m²）	收缩压/mmHg	舒张压/mmHg
DKA组	29	21/0	53.41±18.74	3.00（1.50，10.00）	22.34±2.68	132.00（126.50，138.00）	68（64，72）
DKA合并COVID-19组	36	21/15	62.25±15.51	7.50（5.00，13.75）	22.25±2.42	135.50（129.00，138.00）	68（64，73）
χ²、Z或t		1.393	2.080^＊	2.620^＊＊	0.150	0.345	0.986

组别	n	性别（男/女）	年龄/岁	病程/年	BMI/（kg/m²）	收缩压/mmHg	舒张压/mmHg
DKA组	29	21/0	53.41±18.74	3.00（1.50，10.00）	22.34±2.68	132.00（126.50，138.00）	68（64，72）
DKA合并COVID-19组	36	21/15	62.25±15.51	7.50（5.00，13.75）	22.25±2.42	135.50（129.00，138.00）	68（64，73）
χ²、Z或t		1.393	2.080^＊	2.620^＊＊	0.150	0.345	0.986

组别	n	TC/ （mmol/L）	TG/ （mmol/L）	LDL-C/ （mmol/L）	AST/ （U/L）	ALT/ （U/L）	肌酐/ （μmol/L）	尿酸/ （μmol/L）
DKA组	29	5.05±1.45	1.42（0.83，2.63）	3.11±1.27	35.45±7.46	28.55±5.17	121.79±27.47	372.00（251.00，530.00）
DKA合并COVID-19组	36	4.39±1.26	1.19（0.81，2.12）	2.65±1.11	36.39±9.26	30.28±3.77	121.78±27.25	462.50（359.75，628.75）
Z或t		1.984	1.214	1.540	0.443	1.556	0.002	1.762

组别	n	TC/ （mmol/L）	TG/ （mmol/L）	LDL-C/ （mmol/L）	AST/ （U/L）	ALT/ （U/L）	肌酐/ （μmol/L）	尿酸/ （μmol/L）
DKA组	29	5.05±1.45	1.42（0.83，2.63）	3.11±1.27	35.45±7.46	28.55±5.17	121.79±27.47	372.00（251.00，530.00）
DKA合并COVID-19组	36	4.39±1.26	1.19（0.81，2.12）	2.65±1.11	36.39±9.26	30.28±3.77	121.78±27.25	462.50（359.75，628.75）
Z或t		1.984	1.214	1.540	0.443	1.556	0.002	1.762

组别	n	CK/（U/L）	CK-MB/（U/L）	白细胞计数/（×10⁹/L）	淋巴细胞绝对值/ （×10⁹/L）	血红蛋白/（g/L）
DKA组	29	60.00（45.50，144.00）	17.00（14.50，27.00）	8.19（6.30，10.52）	1.59（0.90，1.70）	144.00（128.50，160.50）
DKA合并COVID-19组	36	97.50（49.70，139.75）	24.00（20.00，36.00）	10.53（8.26，12.94）	0.96（0.64，1.34）	138.50（126.00，154.75）
Z		2.026^＊	2.659^＊＊	2.541^＊	2.488^＊	0.964