63. Prognosis of COVID-19 Patients with Diabetic Ketoacidosis with or Without Hyperosmolar Hyperglycemic State

Background: One of the risk factors for poor outcome with SARS-CoV-2 infection is diabetes mellitus;diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are the most serious complications of diabetes mellitus We aimed to explore the clinical characteristics and outcomes of COVID-19 patients presenting with isolated DKA or combined DKA/HHS to our institution Methods: A retrospective, hospital based observation case series was performed on patients with SARS-CoV-2 admitted to Intensive Care Unit between 03/20/20 and 04/20/20 Inclusion criteria were: 1) Blood Glucose >250mg/dL;2) Serum bicarbonate 10;4) serum pH 304 mOsm/kg Results: A total of 87 patients with COVID-19 were admitted to the ICU during the study period, 12 of them had either isolated DKA or DKA/HHS Baseline demographics, lab values and outcome are summarized in Table 1 Six of the patients had isolated DKA and six had combined DKA and HHS The median age for the patient was 49 5 years old (range from 19 to 62 years old) The male to female ratio was 5:1 Of the 12 patients, 10 patients (83%) had a history of DM, nine were type 2 and only one type 1;two patients were newly diagnosed DM, presenting as DKA, presumptively precipitated by COVID-19 Five patients (42%) had a BMI >30 kg/m2 As for ethnicity;seven were Hispanic (59%), four African American (33%), and one Caucasian (8%) Patients with combined DKA/HHS, higher BMI, higher HbA1c, severe acidosis tended to have higher mortality The striking feature was that isolated DKA or combined DKA/HHS was the initial presentation for COVID-19 for most of the cases Conclusion: Our observational retrospective case series reinforces the need to watch for new onset DM and monitor blood sugar closely in those with known diabetes mellitus during SARS-CoV-2 infection, in order to avoid such serious complications as DKA and HHS (Table Presented)