Abstract: Background: Diabetes Mellitus is an important factor in COVID-19 patients, known as a risk factor for severe SARS-CoV-2 infection. SARS-CoV-2 infection actually causes acute diabetic complications such are DKA and HHS in known diabetic patients, and also some studies and case reports support the idea that COVID-19 could trigger New onset Diabetes. The incidence of DKA is higher than HHS in COVID-19 patients.
Methods: The patient admitted with HHS, was diagnosed with COVID-19 on the bases of basis of Chest Computed Tomography, after a negative reverse transcription-polymerase chain reaction (RT-PCR) assay. Detailed medical history, physical examination and laboratory investigations were obtained.
Case presentation: Here we present a 70 year-old patient, not known to have DM before, presented in ED with somnolence, reporting a 2 weeks history with fever, urinary tract infection signs, fatigue, polyuria-polydipsia syndrome, home treated with antibiotics, with no improvement. His lab results showed high blood glucose, high effective osmolarity, no ketonuria, diagnostic for HHS. He got hospitalized in Endocrinology and Diabetology Department and treated successfully with intravenous fluids and insulin as per HHS protocol. Besides his metabolic improvement his body temperature persisted and a COVID-19 Disease was suspected. So he underwent a Chest Computed Tomography which confirmed SARS-CoV-2 Pneumonia, despite the negative RT-PCR test. The patient refused the treatment in a COVID-19 Hospital and he was discharged home in a stable condition.
Conclusion: COVID-19 has a diabetogenic effect that is yet to be fully understood. Based on the reviewed cases, patients with newly onset diabetes and a recently aggravated symptomatology need a careful investigation regarding the presence of SARS-CoV-2 as a potential trigger.
Keywords: HHS, diabetes, COVID-19, ACE2.
Title: Hyperosmolar hyperglycemic state and New Onset Diabetes Mellitus precipitated by COVID-19 Infection
Author: Adishah Çerma, Pranvera Spahija, Gerond Husi, Marjeta Kërmaj, Klodiana Poshi, Adela Haxhiraj, Violeta Hoxha, AgronYlli
International Journal of Healthcare Sciences
ISSN 2348-5728 (Online)
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