COVID-19 in a patient with insulin-dependent diabetes mellitus

Abstract

Introduction. Throughout the COVID-19 pandemic, multiple studies have shown that certain patients are at especially high risk of developing severe illness or dying from coronavirus infection. Therefore, researchers had pointed out a connection between diabetes mellitus (DM) and COVID-19. Furthermore, DM may be a potential risk factor for the severity of COVID-19 infection. Case presentation. A 67-year-old man with a medical history of HTA gr.III for 5 years (treated with acetylsalicylic acid 75 mg, lercanidipine 20 mg, losartan 100 mg, indapamide 1.5mg and bisoprolol 10 mg) and Insulin-Dependent type I Diabetes Mellitus for 10 years (Actrapid: 8.00 - 18 UN, 12.00 - 8 UN, 18.00 - 8 UN; Protofan: 8.00 - 10 UN, 20.00 - 10 UN) came to the family doctor with suspected COVID-19, following a 3 day history of dry cough, fevers 38C and severe dyspnea. After the diagnosis of COVID-19 infection was confirmed by PCR test, the doctor prescribed the following treatment: 2nd generation cephalosporin, Xarelto 10mg, Famotidine, vit C, D, Zn, gr B which the patient followed for 8 days. On the 8th day due to worsening dyspnea and fever 38C, the patient requested the AMU service and was brought to the emergency department. He was hypoxaemic, with an SpO2 of 90% without ventilator support and with an SpO2 of 94% on 5 L / min oxygen, FR - 20 / min, FC - 64 / min. Discussion. Our purpose with this case report was to present how DM may lead to rapid deterioration of health due to COVID19 infection as DM patients already suffer from organ damage or decreased organ functionality. Conclusion. According to the literature, diabetic patients have a weaker immune system, less viral clearance rate, malfunctions of metabolic activity due to their high blood glucose level, and other associated problems. This does not increase the risk of patients to become infected with COVID-19. However, the severity of COVID-19 can increase due to the comorbidity of DM.