Incidence, characteristics, risk factors and outcomes of diabetic ketoacidosis in COVID ‐19 patients: Comparison with influenza and pre‐pandemic data
Authors' conclusion
The incidence of DKA was higher in COVID-19 cohort compared to the influenza and pre-pandemic cohort. Patients with COVID-19 with DKA had worse outcomes compared with those without. Many COVID-19 survivors who developed DKA during hospitalization became insulin dependent. Identification of risk factors for DKA and new insulin-dependency could enable careful monitoring and timely intervention.
Study context
- Population
- Hospitalized patients in Montefiore Health System, Bronx, NY, USA
- Participants
- 13,383 / 19,165 / 35,000
- Exposure
- COVID-19 vs influenza vs pre-pandemic hospitalized patients
- COVID-19n = 13,383
- Influenzan = 19,165
- Pre-pandemicn = 35,000reference
- Outcome
- Incidence of in-hospital DKA, in-hospital mortality, and insulin use at 3 and 6 months post-infection
Main finding
As reported in the abstract
P < 0.05 pairwise
Observational data: associations, not effects.
Further findings
| Outcome | OR (CI) | P value | |
|---|---|---|---|
| Mortality, COVID-19 with DKAvs without DKA | 6.178 (4.428–8.590) | P < 0.0001 | |
| 0.10.31310Odds ratio (log scale) |
Acute outcomes and new insulin treatment, COVID-19 with diabetic ketoacidosis (DKA) vs influenza with DKA · 3 and 6 months post-infection
- COVID-19 patients with DKA had worse acute outcomes and higher incidence of new insulin treatment at 3 and 6 months vs influenza patients with DKA (p < .05)
DKA incidence in COVID-19 by diabetes status
- T1D
- 12.8%
- Insulin-dependent T2D
- 5.2%
- Non-insulin dependent T2D
- 2.3%
- Without T2D
- 1.3%
Mortality, COVID-19 with DKA vs without DKA
- Worse disease severity with DKA
Risk factors for DKA
- T1D, steroid therapy for COVID-19, COVID-19 status, black race and male gender associated with increased DKA risk
Original publication
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