Blood Glucose Levels and Severity of COVID-19 in Patients with Diabetes Mellitus in Intensive Care Unit: A Case Series

Abstract

Introduction: The severity of coronavirus disease 2019 (COVID-19) ranges from mild flu to respiratory distress and death. Diabetes mellitus (DM) is considered as one of the risk factors for infection susceptibility and disease severity. This case series reports the clinical features, ancillary test findings, and mortality in patients with severe COVID-19 and DM.
Case Illustration: This study reports three female patients, aged 50-68 years old, with severe COVID-19 and DM whom were hospitalized in intensive care unit from April to July 2020. Two patients presented with hyperglycemia upon admission. During hospitalization, two patients tended to be hyperglycemic, while the other one had more episodes of hypoglycemia. Two patients suffered from hospital-associated pneumonia and acute kidney injury throughout hospital stay. One patient passed away.
Discussion: All patients had fluctuating general condition and unstable blood glucose levels during hospitalization. One patient passed away due to respiratory distress, while the other two were discharged after their general condition improved. Hyperglycemic and hypoglycemic states in DM patients are proposed to play a role in the severity of COVID-19 infection.
Conclusion: DM may aggravate COVID-19 infection. Initial normal blood glucose levels upon admission does not guarantee good prognosis; therefore, blood glucose control in COVID-19 patients remains extremely crucial.