New-Onset Diabetes in Children during COVID-19: Clinical Cas
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Data of COVID-19 in newborns and children are limited, and clinical manifestations are nonspecific and might delay the diagnosis, which might lead to severe complications. This clinical case describes new-onset diabetes with consciousness impairment as an atypical revealing way of COVID-19.

A 3-year-old child presented to the Emergency Department with loss of consciousness (without fever), lethargy, and stupor. Clinical assessment on admission found an unconscious child with a pediatric Glasgow Coma Scale of 10/15 with no localizing signs or meningeal syndrome, polypneic of 35 breaths/min, pulse oximetry of 90%, with signs of overall dehydration: skin folds, sunken eyes, tachycardia of 160 beats/minute, and recoloring time superior at 3 seconds.

Laboratory findings showed hyperleukocytosis of 16000/mm3, lymphopenia of 450/mm3, glycemia of 5 g/L with a correct ionogram: corrected natremia of 139 mmol/L, serum potassium of 4.5 mmol/L, glycosuria of 3+, ketonuria of 2+, and HbA1c of 10%, and COVID-19 RT-PCR came back positive.

COVID-19 might be revealed with atypical symptoms including new-onset diabetes and diabetic ketoacidosis; therefore, clinicians must suspect it in children with blood glucose and HbA1c at the time of admission. This will help to manage patients with hyperglycemia early.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879331/
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