Acute uncontrolled hyperglycemia, a non-specific presentation and predictor of covid-19 severity- a report of three cases

Mensah Boniface; Roberta Norman Betty; Kweku Annan John Jude; Kokuro Collins

doi:10.30574/gscarr.2021.6.1.0001

Authors

Mensah Boniface Kumasi South Hospital P.O. Box 1908, Atonsu Agogo, Kumasi, Ghana.
Roberta Norman Betty Department of Internal Medicine School of Medicine and Dentistry, College of Health Sciences Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Kweku Annan John Jude Department of Obstetrics and Gynaecology School of Medicine and Dentistry, College of Health Sciences Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Kokuro Collins Department of Internal Medicine School of Medicine and Dentistry, College of Health Sciences Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

DOI:

https://doi.org/10.30574/gscarr.2021.6.1.0001

Keywords:

Coronavirus disease 2019, COVID-19, Hyperglycemia, Diabetes mellitus, Case reports

Abstract

Coronavirus disease 2019 (COVID-19) is a pandemic caused by the severe acute respiratory coronavirus 2 (SARS Cov-2) which currently has caused over 76 million cases with over 1.6 million people dead worldwide. COVID-19 can manifest with several non-specific clinical presentations, posing a diagnostic challenge. Several studies have shown an increased COVID-19 severity in patients with Diabetes mellitus. However, some patients with COVID-19 severity may present with new-onset Diabetes mellitus or worsening blood glucose control in a known diabetic. There are various mechanisms by which the SARS Cov-2 causes hyperglycemia in infected patients. This can lead to hyperglycemia as a presentation of COVID-19 in the absence of specific signs and symptoms. We present three cases: two of them initially presented with acute onset hyperglycemia and were diagnosed with Diabetes mellitus but shortly developed clinical manifestations that led to the suspicion of COVID-19 and a positive COVID-19 RT-PCR test. The third was a diabetic with previously good glycaemic control which suddenly worsened for no reason and shortly after, also developed clinical manifestations that led to the suspicion of COVID-19 which was later confirmed.

We recommend that patients with acute hyperglycemia state and/or worsening blood glucose control in patients with previously well controlled Diabetes mellitus should be evaluated for COVID-19 in order to reduce morbidity and mortality as hyperglycemia confers an increased disease severity.

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References

Global Map. Coronavirus Resource Center Johns Hopkins University

Gupta, Aakriti, Mahesh V. Madhavan, Kartik Sehgal, Nandini Nair, Shiwani Mahajan, Tejasav S. Sehrawat, Behnood Bikdeli, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Landry DW. “Extrapulmonary Manifestations of COVID-19.” Nature Medicine. July 2020; 26(7): 1017–32.

Yang, Jin-Kui, Shan-Shan Lin, Xiu-Juan Ji, Li-Min Guo. “Binding of SARS Coronavirus to Its Receptor Damages Islets and Causes Acute Diabetes.” Acta Diabetologica. September 2010; 47(3): 193–99.

Harmer, Dan, Maureen Gilbert, Richard Borman, Kenneth L Clark. “Quantitative MRNA Expression Profiling of ACE 2, a Novel Homologue of Angiotensin Converting Enzyme.” FEBS Letters. 4 December 2002; 532(1–2).

Hussain, Akhtar, Bishwajit Bhowmik, and Nayla Cristina do Vale Moreira. “COVID-19 and Diabetes: Knowledge in Progress.” Diabetes Research and Clinical Practice. April 2020; 162: 108-142.

Eizirik, DL, MI Darville. “Beta-Cell Apoptosis and Defense Mechanisms: Lessons from Type 1 Diabetes.” Diabetes 50, no. Supplement. 1 February 2001; S64–69.

Brufsky, Adam. “Hyperglycemia, Hydroxychloroquine, and the COVID‐19 Pandemic.” Journal of Medical Virology. July 2020; 92(7): 770–75.