An insight to the diabetic ketoacidosis and lactic acidosis among the SARS-COV2 infected individuals

A huge number of studies have demonstrated the significance correlation between diabetic ketoacidosis as well as other type of ketosis/hyperosmolar metabolic state deterioration conditions and the SARS-COV2 infection. It is investigated in various infected age group, geneders, and countries. It is reported to be correlated to the two types of diabetes (type I DM and type II DM) available as pre-existing co-morbidity, infection related new-onset developed diabetes of both types or even due to hyperinflammation related acute pancreatitis. In fact, although most of the studies have reported greater survival, however, small single center retrospective studies have reported the association of diabetic ketoacidosis with elevated mortality rate that approaches 50%. Mechanistically, the DKA caused metabolic state deterioration due to the glucose metabolism fluctuation is attributed to the bidirectional sophisticated SARS-COV2 infection and different reasons hyperglycemia disease-disease interaction. Nevertheless, exaggerated inflammatory/immune response may also worsen the glycemic state that brings about ketosis. Remarakably, DKA can be developed even in cases of approximately normoglycemic conditions of the SARS-COV2 infection which is fewly reported, yet, it is attributed to SGLT2 inhibitors therapy. The SARS-COV2 infection related DKA complication among diabetic individuals have been treated with the same therapeutic protocol of non-infectious conditions including insulin and IV replenishment therapy however, with significantly greater dosing regimen. It is worthy to note that the infused replenishment fluids should be carefully calculated along with monitoring the lung function besides careful monitoring the potassium and some other electrolytes level particularly while insulin is intravenously infused. Thus, in order to explore the significance of correlation of this metabolic complication with the virus infection poor prognosis as well as higher mortality rate this survey reports the development of DKA as well as the ketosis related metabolic abnormailities while the course of SARS-COV2 infection among individuals with pre-exisitng and new onset diabetes.