Diabetic Emergencies presenting during the COVID-19 Pandemic: A Retrospective Case Analysis

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 COVID19 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 this data to 9 patients with no COVID-19. Results: 30 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: Little is known about the metabolic disturbances COVID-19 has on diabetic patients. Further, prospective detailed investigation into biochemical processes is needed to elucidate underlying mechanisms that affect these patients’ outcomes.