Document Type : original article
Authors
1 Professor of Pediatric Endocrinology, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2 Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
3 Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
4 Clinical Research Development Unit of Akbar Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
5 Associate Professor of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract
Background: Diabetic ketoacidosis can be the first manifestation of type 1 diabetes in children at the time of diagnosis. Some studies regarding the impact of the COVID-19 pandemic on the incidence and severity of DKA in children. The aim of this study was to investigate the status of diabetic ketoacidosis before and during COVID-19.
Methods: This cross-sectional study was conducted at Akbar Pediatric Super-specialty Hospital in Mashhad that included one year before and one year after the start of the pandemic of COVID-19. All children under 18 years old admitted with a diagnosis of DKA based on the 2018 ISPAD protocol were included in the study. For each of them, a checklist was completed. After collection, the data was entered into SPSS software and analyzed. A significance level of 0.05 was set for all inferential statistical tests.
Results: A total of 310 patients were included in the study, of which 176 (56.8%) were male and the rest were female. In 2018, only 33% of new cases were diabetic, while in 2020, this rate had reached 57.2% (p=0.006). 18.4% of patients during the COVID-19 era had bicarbonate levels less than 5 upon admission, whereas during the pre-COVID era, only 5.3% of patients had bicarbonate levels less than 5. The rate of ICU admission in 2020 was significantly higher than in 2018 (p=0.003) so that 15.9% of patients were admitted to the ICU in 2020.
Conclusion: Based on the results of our study, the rate of patients diagnosed with diabetes and diabetic ketoacidosis significantly increased during and after the COVID-19 pandemic.
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