New-onset Type 1 Diabetes Mellitus with Diabetic Ketoacidosis and Pancreatitis in a Patient with COVID-19

Mostafa Alfishawy; Mahmoud Nassar; Mahmoud Mohamed; Moataz Fatthy; Riem M Elmessiery

doi:10.1016/j.sciaf.2021.e00915

New-onset Type 1 Diabetes Mellitus with Diabetic Ketoacidosis and Pancreatitis in a Patient with COVID-19

Sci Afr. 2021 Sep:13:e00915. doi: 10.1016/j.sciaf.2021.e00915. Epub 2021 Aug 3.

Authors

Mostafa Alfishawy¹, Mahmoud Nassar², Mahmoud Mohamed³, Moataz Fatthy⁴, Riem M Elmessiery⁴

Affiliations

¹ Infectious diseases, Infectious Diseases Consultants and Academic Researchers of Egypt (IDCARE), Cairo, Egypt.
² Internal Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals / Queens, 82-68 164th St., Queens, New York, 11432, USA.
³ Medicine department, North Mississippi Medical Center, Tupelo, MS, USA.
⁴ Internal medicine, Faculty of medicine, Cairo university, Cairo, Egypt.

Abstract

Coronavirus Disease 2019 (COVID-19) had struck the world with health and economic catastrophes and recently with unusual autoimmune presentations, including new-onset Type 1 Diabetes. Herein we present a 17-year-old male patient who presented to the outptient clinic with fever, palpitation, and cough of four-week duration; he was referred to the emergency room and was found to have DKA. CT of the chest showed ground-glass opacities suggestive of COVID-19 pneumonia, and abdominal cuts showed dilated intrahepatic biliary radicles with pancreatic loculations suggestive of pancreatitis. The patient was admitted to the ICU, started on intravenous fluids and insulin infusion then COVID-19 PCR returned positive. We hypothesize that SARS-CoV-2 has a vital role in eliciting an autoimmune response triggering type 1 diabetes, and further studies are needed to confirm this hypothesis. SARS-CoV-2 may cause pancreatitis, and the first presentation could be high blood sugar or DKA.

Keywords: COVID-19; DKA; Diabetic ketoacidosis; New-onset; Pancreatitis; Type 1 diabetes mellitus.