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Risk of severe change in diabetic children with Covid-19

NNT girl, 14 years old, lives in Tien Giang, has a history of diabetes, has Covid-19 then fell into a coma, had to be intubated, mechanical ventilation.

Doctor Nguyen Minh Tien, deputy director of the City Children’s Hospital, said that through taking the medical history recorded on day 1 and 2, the children had high fever, vomiting, no cough, no loose stools, and ate little. On the 3rd day, he was delirious, groaning, admitted to the hospital in Tien Giang province in a state of shock, lethargy, rapid test. SARS-CoV-2 positive.

At the local hospital, the child was intubated, anti-shock fluids, vasopressors, antibiotics, the condition did not improve, transferred to the City Children’s Hospital.

Before that, in November 2020, the child was discovered diabetessubcutaneous insulin treatment, periodic follow-up at local hospital.

When transferred to the emergency department of the City Children’s Hospital, the child was comatose, breathing through the endotracheal machine with a ventilator, light pulse 150 times/minute, increased inflammatory response, kidney damage.

Children are diagnosed ketoacidosisThis is an acute, severe complication of diabetes caused by excessively high blood sugar that produces too much acid in the blood (called ketones), the risk of death if not detected and treated promptly.

The doctor treated with fluid resuscitation, anti-shock, infusion of vasopressors to support breathing, mechanical ventilation, insulin, antiviral, anti-inflammatory, anticoagulant antibiotics.

Results after 1 week of treatment, the child gradually improved, was awake, weaned from the ventilator, stable blood sugar, the child was transferred to the Department of Nephrology and Endocrinology for treatment.

Previously, the Department of Nephrology and Endocrinology also received a 2-year-old child with a ketoacidosis coma due to type 1 diabetes, septic shock, and sepsis on day 2 of Covid-19 infection.

Risk of severe change in diabetic children with Covid-19 - Photo 1
Children diagnosed with ketoacidosis due to type 1 diabetes are actively treated, currently health stable


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Pay attention when your child has a fever, vomiting, urinating a lot, and losing weight

Dr. Tien said, a study recorded that from March to May 2020, 532 children in Germany were diagnosed with type 1 diabetes, with 45% presenting with a ketoacidosis coma, almost twice as high as in the previous year. before (24.5%). In the United Kingdom, investigators report the number of children with type 1 diabetes in 2020-2021, an 80% increase from previous years.

The explanation for this phenomenon can be due to many factors such as delayed medical care, the impact of infection SARS-CoV-2 or sick with Covid-19. In each person, ACE2 receptors are present in many organs such as the respiratory tract, lungs, heart, liver, kidneys, etc., including exocrine organs and endocrine tissues of the pancreas.

“SARS-CoV-2 binds to ACE2 receptors allowing the virus to enter and damage the islets of the pancreas, leading to acute diabetes and possibly triggering ketoacidosis,” said Dr. accumulate.

Doctor Tien advises parents when seeing their children have a fever, vomiting, eat a lot, urinate a lot, lose weight, etc., take them to a hospital with a specialist in pediatrics for an accurate examination and diagnosis. appropriate treatment for children.

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