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Evaluation of the impact of diabetic ketoacidosis on the outcomes of ICU patients with COVID-19 and concurrent diabetes: A single-center retrospective cohort study

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International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Objective

This study aims to evaluate the impact of diabetic ketoacidosis (DKA) on clinical outcomes among intensive care unit (ICU) patients diagnosed with COVID-19 and concurrent diabetes.

Methods

A retrospective analysis was conducted on ICU patients diagnosed with both COVID-19 and diabetes at a tertiary-level hospital. Patients were stratified into two groups, non-DKA and DKA, based on the presence of DKA. Comparative analyses were performed to assess clinical characteristics, laboratory parameters, treatment modalities, and prognostic outcomes between the two groups.

Results

The study included 111 ICU patients with COVID-19 and concurrent diabetes, comprising 88 patients in the non-DKA group and 23 patients in the DKA group. Compared to the non-DKA group, the DKA group exhibited a significantly higher proportion of female patients, younger age, and lower prevalence of hypertension, cardiac, and renal comorbidities (p < 0.05). The overall mortality rate was 43.5% in the DKA group, which did not significantly differ from the 55.7% observed in the non-DKA group (p = 0.336).

Conclusion

Among patients with COVID-19 and concurrent diabetes, the presence of DKA is not associated with increased mortality. This observation may be attributed to the younger age of patients in the DKA group, reduced organ support requirements, and shorter treatment duration.

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Data Availability

The datasets used and/or analyzed during the current study are not publicly available due to institutional restrictions but may be available from the corresponding author upon reasonable request.

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Funding

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Authors

Contributions

All authors contributed to the study design and manuscript preparation. Specific roles include drafting, data collection, analysis, and supervision.

Corresponding authors

Correspondence to Tong Sha, Yaoyuan Zhang or Zhenhua Zeng.

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Ethics approval and informed consent

The study was approved by the Ethics Committee of Nanfang Hospital of Southern Medical University (Ethics Approval Number: NFEC-202212-K7). Informed consent was waived due to the retrospective nature of the study.

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The authors declare no conflicts of interest.

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Liu, L., He, Z., Tao, S. et al. Evaluation of the impact of diabetic ketoacidosis on the outcomes of ICU patients with COVID-19 and concurrent diabetes: A single-center retrospective cohort study. Int J Diabetes Dev Ctries (2025). https://doi.org/10.1007/s13410-025-01468-z

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  • DOI: https://doi.org/10.1007/s13410-025-01468-z

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