No 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.

Background: According to the evidence, coronavirus disease 2019 (COVID-19) is associated with significant mortality among hospitalized patients. Corticosteroid drugs have had different effects on disease-associated fatality. This study aimed to evaluate the corticosteroid-associated mortality rate and its related risk factors in the southern Iranian population infected by COVID-19. Methods: A retrospective study was conducted on the adult population aged≥20 years admitted to Shahid Mohammadi hospital in Bandar Abbas, Iran between February 2020 and October 2020. All subjects were confirmed for COVID-19 by reverse transcriptase-polymerase chain reaction (RT-PCR). Results: Among 1610 included cases, 150 (9.3%) died. Also, 58.5% and 58.7% of the total hospitalized and mortality cases were male, respectively. The mortality rate in subjects older than 60 years was 2.5 times higher than patients aged 40 years, which was statistically significant (P<0.001). The results of logistic regression analysis revealed that age was the most significant risk factor for mortality. The elderly patients (>60) had nearly ten times higher chance of fatality than patients aged less than 40 years (adjusted odds ratio [aOR]: 9.79, 95% CI: 4.41-21.74). Using corticosteroids independently increased the chance of mortality by 50% (aOR: 1.53, 95% CI: 1.06-2.22). Low oxygen saturation (<93%) raised mortality rate by more than 3.5 times compared to oxygen saturation≥93% (aOR: 3.67, CI 95: 2.54-5.31). In addition, ischemic heart disease (IHD) was another remarkable predictor of death (aOR: 2.85, 95% CI: 1.88-4.31). Conclusion: According to our results, corticosteroids had no benefits for reducing the mortality rates among COVID-19 patients. Further randomized clinical trials are suggested to evaluate the effects of corticosteroids on COVID-19-related mortality.