Diabetic ketoacidosis among Egyptian children and adolescents in the coronavirus disease 2019 era: a single-center retrospective study

Abstract

Introduction There is a recent debate regarding the effect of coronavirus disease 2019 (COVID-19) pandemic on the frequency of type 1 diabetes mellitus (T1DM) and its acute complications, mainly diabetic ketoacidosis (DKA). Several reports showed a significant upward trend in the frequency of DKA among children and adolescence with T1DM. Studies showed a significant escalation in the number of cases with severe DKA compared with the previous years. Objectives To assess the effect of COVID-19 on the frequency and severity of DKA among children and adolescents with T1D. Patients and methods A retrospective study was performed between January 2019 and December 2020. It included 177 children and adolescents admitted to the Pediatrics Department at Suez Canal University Hospital. Results In the COVID era, the mean age of the admitted children with diabetes was 8.6±3.9 years. Newly diagnosed T1DM was seen in 67.9% of the patients who had DKA, which was higher than the previous year (56.1%). DKA severity increased and was significantly higher in 2020 compared with those admitted in 2019 (P=0.001). Additionally, moderate and severe DKA grades were significantly frequent among COVID-19-positive compared with negative ones (P=0.041), with significantly lower PH (P=0.016) and lower bicarbonate level (P<0.001). Conclusion The COVID-19 pandemic influenced T1DM presentations and DKA severity, especially during the recorded waves.