A Pregnant Woman With COVID-19, Diabetic Ketoacidosis, and Pancreatitis

Masoumeh Kheirandish, Feysal Yousefzade, K. Seddighi, Mojtaba Khademi Bafrouie, A. Rahimi
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Abstract

The novel coronavirus infection 2019 (COVID-19) is a pandemic viral disease officially named by World Health Organization (WHO) on March 11, 2020. It is mainly a respiratory disease but can involve other organs. Extrapulmonary presentations are broad and not well recognized. COVID-19 may trigger diabetic ketoacidosis (DKA) in a patient with adequately controlled diabetes. Pregnancy is an incomplete immune suppression status, making women more susceptible to infections, and the disease-related morbidity is higher during pregnancy. Herein, we present the case of a 23-year-old diabetic pregnant woman at 28 weeks gestation with acute pancreatitis, DKA, hypertriglyceridemia, with confirmed COVID-19 infection using polymerase change reaction (PCR). She underwent antiviral therapy, adequate intravenous hydration, insulin infusion, and plasmapheresis in the intensive care unit (ICU). Her condition ultimately improved. COVID-19 with simultaneous pregnancy and diabetes mellitus increases the risk of metabolic disorders. Therefore, rapid diagnosis and adequate management would be considered.
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1例合并COVID-19、糖尿病酮症酸中毒和胰腺炎的孕妇
新型冠状病毒感染2019 (COVID-19)是世界卫生组织于2020年3月11日正式命名的大流行性病毒性疾病。它主要是一种呼吸系统疾病,但也可累及其他器官。肺外表现广泛,但未得到很好的认识。在糖尿病控制良好的患者中,COVID-19可能引发糖尿病酮症酸中毒。怀孕是一种不完全的免疫抑制状态,使妇女更容易受到感染,怀孕期间疾病相关发病率较高。在此,我们报告了一例23岁的糖尿病孕妇,妊娠28周,急性胰腺炎,DKA,高甘油三酯血症,经聚合酶改变反应(PCR)确诊为COVID-19感染。她在重症监护室(ICU)接受了抗病毒治疗、充足的静脉补水、胰岛素输注和血浆置换。她的病情最终有所好转。同时妊娠和糖尿病的COVID-19增加了代谢紊乱的风险。因此,应考虑快速诊断和适当的治疗。
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