ESPE Abstracts

Introduction: During this year, scientific research revolves around COVID-19, with so many unanswered queries in term of pathogenesis; complications, and mortality rate; in light of limited pediatric evidence. The close relation between COVID 19 and new-onset diabetes especially in children is still an unresolved issue. Our paper, exhibits an unique presentation of DKA misleading COVID 19 diagnosis at this age

Case presentation: A three-year-old boy admitted for a history of acute dyspnea besides vomiting and weight loss, without abdominal discomfort. His vital parameters were monitored : temperature was 38°C, respiratory rate up to 50 breaths per minute without Kussmaul breathing however he had obvious respiratory distress signs particularly nasal flaring and chest retractions, his oxygen saturation was initially about 93 % under 3 liters of oxygen provided by a simple facial mask. The child’s capillary blood glucose was checked; reaching 3 g/l with 3+ of ketones besides 3+ of glucose in the urine test. The remainder of his physical examination was uneventful. The diagnosis of a mild DKA was obviously assessed (pH: 7,25, Bicarbonate : 13,2 meq/l with decreased alkaline reserve : 8 meq/l). However, obvious respiratory distress signs didn’t disappear even though glycaemic levels were normalized and acidosis was resolved. The boy was tested positive for Covid-19 just as his parents while they were asymptomatic. Then, the patient inderwent a Chest computed tomography revealing bilateral ground-glass opacities especially in subpeural region with left consolidations; graded CO-RADS 4 by the radiologist. After 48 hours in the intensive care; his clinical condition gently improved. The patient started breathing room air; and was moved to an isolation COVID-19 care unit with his mother. Basal bolus insulin regimen was started, and diabetes education was provided and evaluated through sessions pursued even after the hospital’s discharge. Our boy’s HbA1c value was 10,3% ; and his islet autoantibodies were positive. After 10 days in the hosiptal, the patient and his mother were discharged with quarantine recommandation.

Conclusion: As a diabetologist; the correlation between COVID 19 and new-onset diabetes especially in children is still an unresolved issue. Higher attention is required to enhance COVID-19 linked diabetic ketoacidosis prognosis and the global registry of cases with COVID-19-related diabetes (Cov-iDIAB project) should be enrished in order to conduct further studies.