Article:
Clinical Dilemma of Diabetic Ketoacidosis and COVID-19 Infection

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Abstract
ABSTRACT The COVID-19 Pneumonia with diabetic ketoacidosis is a dreadful health condition. Diabetic ketoacidosis is one of the severe metabolic complications and it can be precipitated by infection. We presented a case of 48 years female with no known comorbidities who presented with COVID-19 symptoms and with Diabetic Ketoacidosis. The case presented with elevated inflammatory markers, high anion gap metabolic acidosis with type I respiratory failure. During admission, the oxygen saturation had marked drop, later her improvement was steady followed by gradual tapering of the oxygenation. Marked improvement was noticed in the subsequent follow-up. COVID-19 infection can be precipitated by preexisting diabetes or newly diagnosed diabetes and the severity of COVID-19 infection is more pronounced in patients with diabetes mellitus, thus should be managed timely and accordingly. The scarce studies among the COVID-19 cases with diabetic ketoacidosis reflect the need for further studies for the availability of a wider range of information. KEY WORDS Diabetic ketoacidosis, Metabolic complications, Severe COVID-19 pneumonia
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Sapkota P,1 Chalise S,1 Shrestha P2 1Department of Internal Medicine 2Department of Public Health and Community Programs Dhulikhel Hospital, Kathmandu University Hospital Kathmandu University School of Medical Sciences Dhulikhel, Kavre, Nepal
Keywords
Diabetic ketoacidosis, Metabolic complications, Severe COVID-19 pneumonia

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