Diabetic Ketoacidosis at Onset of Pediatric Type-1 Diabetes Triggered by Covid-19: An Original Case Report

Abstract

During the course of this year, scientific research has revolved around coronavirus disease 2019 (COVID-19), with much uncertainty surrounding its pathogenesis, complications, and mortality as well as limited pediatric evidence. The exact relationship between COVID-19 and new-onset type 1 diabetes, especially in children, remains an unresolved issue. Our case exhibited a unique presentation of diabetic ketoacidosis (DKA) triggering COVID-19 diagnosis at this age. A three-year-old Moroccan boy was admitted with a history of acute dyspnea accompanied by vomiting and weight loss, leading to a diagnosis of DKA. However, evident respiratory distress signs did not disappear, even though glycemic levels were normalized and acidosis resolved. The boy subsequently tested positive for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), with specific biological and radiological findings. Our clinical case potentially augmented the global registry of COVID-19-related diabetes (CoviDiab project) cases and provides a basis for further studies that seek to elucidate the correlation between new-onset type 1 diabetes and SARS-CoV-2 in the pediatric population.

New-Onset Diabetes Mellitus Presenting As Diabetic Ketoacidosis in Patients With COVID-19: A Case Series

“…In a case series reported by Suwanwongse and Shabarek, three cases of newly diagnosed DM were associated with COVID-19, of which, two patients were diagnosed with DKA and the other came in with hyperglycemia after being diagnosed with COVID-19 [ 10 ]. Rabizadeh et al and Benyakhlef et al both reported cases of young patients with new-onset DM presenting as DKA; the latter being complicated by pneumonia [ 12 , 13 ].…”

COVID-19 induced type 1 diabetes: A systematic review of case reports and series

“…Following removal of duplicates and the exclusions, 20 studies were eligible for the systematic review (Figure 1). [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] Seven of the studies were conducted in Europe, five in USA, four in North Africa, and four in Asia (Table 1). In terms of design, two studies were case series and 18 were case reports In total, there were 37 cases of new onset T1D.…”

Coronavirus as a trigger of lymphocytic hypophysitis in an adolescent girl: An exceptional case report

“…In addition, there were many reported cases of isolated diabetes insipidus as sequelae of COVID-19 viral infection without MRI abnormality. Furthermore, case reports of type 1 diabetes after COVID-19 infection have been also described [ 13 , 14 ].…”