Acute Hyperglycemic Crises with Coronavirus Disease-19: Case Reports

Abstract

Since the first case was contracted by coronavirus disease-19 (COVID-19) in Daegu, Korea in February 2020, about 6,800 cases and 130 deaths have been reported on April 9, 2020. Recent studies have reported that patients with diabetes showed higher mortality and they had a worse prognosis than the group without diabetes. In poorly controlled patients with diabetes, acute hyperglycemic crises such as diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS) also might be precipitated by COVID-19. Thus, intensive monitoring and aggressive supportive care should be needed to inadequately controlled patients with diabetes and COVID-19 infection. Here, we report two cases of severe COVID-19 patients with acute hyperglycemic crises in Korea.

Keywords: Acidosis; COVID-19; Diabetes complications; Hyperglycemia; Ketosis.

Fig. 1. Case 1. Chest radiographs, at admission (A), 3rd day of hospitalization, peribronchial ground-glass opacities (GGOs) in both lungs (B), 6th day of hospitalization, exacerbation of peribronchial GGOs and nodular opacities in both lungs (C), 15th day of hospitalization (D).

Fig. 2. Case 2. Chest radiographs, at admission, atherosclerotic cardiovascular change, increased cardiothoracic ratio and pulmonary vasculature, multifocal patchy consolidation at both lung field (A), 2nd day of hospitalization, minimal improving status of consolidation (B), 20th day of hospitalization, more progression of both lung field consolidation (C), 33rd day of hospitalization, minimal improving status of consolidation (D).