Han Min Jeong, Heo Jun Ho
Department of Pediatrics, Chonbuk National University Hospital, Jeonju, 54907, Korea.
Department of Emergency Medicine, Wonkwang National University Hospital, Iksan, 54887, Korea.
Diabetes Metab Syndr Obes. 2021 Feb 22;14:783-790. doi: 10.2147/DMSO.S294458. eCollection 2021.
We evaluated the clinical characteristics and severity of diabetic ketoacidosis (DKA) in children before and after the coronavirus disease 2019 (COVID-19) outbreak to identify its indirect effects on DKA incidence.
This retrospective study included 19 children with DKA admitted to the emergency room (ER) in two centers in Jeonbuk province, Korea during the first 6 months of the year from 2017 to 2020. Data were collected on age, height, body weight, clinical symptoms, diabetic mellitus (DM) type, and laboratory findings. DKA severity was based on the presence of acute kidney injury, cerebrovascular accident, and altered mental status. The ratio of patients with DKA in all pediatric patients who visited the study ERs and in the Jeonbuk population was also determined.
There were no differences in anthropometric characteristics and complication rates between the pre-COVID-19 and COVID-19 periods; however, the rate of polydipsia was significantly higher in the COVID-19 period. All seven patients admitted during the COVID-19 pandemic (100%) had polydipsia and polyuria and were newly diagnosed with DM. The rate of pediatric patients with DKA admitted to the ER in 2020 (0.459%) was more than twice the mean rate of 0.206% for the four-year period. The incidence of DKA in the Jeonbuk population (0.00141%) also exceeded the mean rate (0.0009%).
The incidence of pediatric DKA might be higher due to the indirect effect of COVID-19 pandemic. Physicians should be aware of nonspecific symptoms related to DKA in children admitted to the ER.
我们评估了2019年冠状病毒病（COVID-19）疫情前后儿童糖尿病酮症酸中毒（DKA）的临床特征和严重程度，以确定其对DKA发病率的间接影响。
这项回顾性研究纳入了2017年至2020年期间韩国全北道两个中心急诊室收治的19例DKA患儿。收集了年龄、身高、体重、临床症状、糖尿病类型及实验室检查结果等数据。DKA严重程度基于是否存在急性肾损伤、脑血管意外及精神状态改变。还确定了在研究急诊室就诊的所有儿科患者及全北道人群中DKA患者的比例。
COVID-19疫情前和疫情期间人体测量特征及并发症发生率无差异；然而，COVID-19期间烦渴发生率显著更高。在COVID-19大流行期间收治的所有7例患者（100%）均有烦渴和多尿，且均为新诊断的糖尿病患者。2020年急诊室收治的儿科DKA患者比例（0.459%）是四年平均比例0.206%的两倍多。全北道人群中DKA的发病率（0.00141%）也超过了平均发病率（0.0009%）。
COVID-19大流行的间接影响可能导致儿科DKA发病率升高。医生应警惕急诊室收治的儿童中与DKA相关的非特异性症状。
