Diabetes Ketoacidosis: New Onset Diabetes with Diabetic Ketoacidosis After SARS-CoV-2 Infection in Adult Critically Ill Patient

Patients affected by diabetes have a higher rate of hospitalization and mortality after a SARS-CoV-2 infection. Diabetes is indeed a negative prognostic factor for coronavirus disease 2019 (COVID-19) and can increase its risk of severity and mortality by more than two times. Furthermore, although on one hand people with diabetes are more at risk of developing complications from COVID-19, the SARS-CoV-2 infection could also act as a diabetic agent by binding to ACE2 in the pancreatic beta-cells and causing their acute dysfunction. To date, there are few data on the impact of the COVID-19 disease on the onset of insulin-dependent diabetes in adult patients. We evaluated the pathophysiological mechanisms binding COVID-19 and diabetes mellitus by discussing the clinical case of a 47-year-old woman admitted to the intensive care unit for coma due to diabetic ketoacidosis secondary to SARS-CoV-2 infection. The patient was successfully treated with acute rehydration, normalization of glycemia, and chronic administration of insulin to maintain normal blood glucose levels.