Clinical profile and outcome of children with diabetic ketoacidosis admitted in a tertiary care centre in kerala during the pre and post COVID period

Abstract

Objective: To study clinical profile and outcome of children admitted with diabetic ketoacidosis in our tertiary care centre during the pre and post covid period (Jan 2016 – Jan 2022). Materials and Methods: Hospital-based cohort study among the children admitted with DKA in the department of Paediatrics. We abstracted the data of children, satisfying the inclusion criteria as per the pre-designed proforma based on ISPAD 2018 guidelines. Participants: 46 children admitted with diagnosis of DKA during the study period, in a tertiary care centre in Kerala. Results: Total of 46 admissions with DKA including 16 readmissions in 30 children were enrolled in the study. Majority (95.65%) were Type 1 DM with mean age of 11.6 years and male to female ratio of 1.1:1. There were 11.5 admission per year after the Covid 19 outbreak, compared to 5.8 cases per year during the pre-covid period. Most of the patients (60.9%) had only a short duration of symp toms (≤ 3 days) at presentation, and vomiting was the commonest symptom (63%), followed by polyuria, polydipsia (60.9%). 47.8% patients presented with mild DKA followed by 34.8% as severe DKA and majority (60.9%) needed 4 to 7 days of hospital stay. Conclusion: DKA is a leading cause of morbidity and mortality in children with diabetes. There is a significant increase in the frequency of children getting admitted with DKA in the post Covid period which may be due to the delay in diagnosing the condition because of sedentary life style during lockdown, unhealthy eating habits and poor utilization of health care system by the public during the early surge of COVID peak.