Treatment of Covid-19 in a pre-diabetic patient in the intensive care unit: a case report
DOI:
https://doi.org/10.33448/rsd-v11i7.30146Keywords:
Type 2 Diabetes Mellitus; Comorbidity; Obesity; COVID-19; Intensive Care Units.Abstract
Coronavirus disease (COVID-19) has been widely and globally studied and researched, as it is a new disease with a varied clinical spectrum and its pathophysiology is not completely known. Moreover, the aggravations are associated with the lifestyle and previous diseases of the patients, and the evolution of each patient. Among these problems are obesity and diabetes, diseases that lead to metabolic disorders in the body. The aim of this report is to report the case of a pre-diabetic patient, obese grade II, with infection caused by the Sars-CoV-2 virus and evolution to diabetes during infection, besides presenting secondary physiological repercussions to the infection. The patient studied was diagnosed with Type 2 Diabetes during hospitalization and presented multiple ground-glass opacities with bilateral multifocal distribution on chest computed tomography (CT), so he was referred to the Intensive Care Unit (ICU). In the ICU, he was positive for SARS-Cov-2 by RT-PCR, Orotracheal Intubation was performed, pharmacotherapy was started, and laboratory tests confirmed that the patient is diabetic. In this case, it is notable that because the patient had comorbidities for COVID-19 - pre-diabetes and grade 2 obesity - the disease may have been aggravated by the factors. Thus, he needed pulmonary rehabilitation and intensive care, such as use of medications used in more advanced cases of the disease and ICU monitoring. Therefore, we conclude that it is essential for health professionals to know the clinical picture and pre-existing pathologies of the affected patients, because this data will offer the professional the choice of individualized therapies.
References
ANVISA. (2020). Nota Técnica GVIMS/GGTES/ANVISA Nº 04/2020 - Orientações para serviços de saúde: medidas de prevenção e controle que devem ser adotadas durante a assistência aos casos suspeitos ou confirmados de infecção pelo novo coronavírus (SARS-CoV-2). https://www.gov.br/anvisa/pt-br/centraisdeconteudo/publicacoes/servicosdesaude/notas-tecnicas/nota-tecnica-gvims_ggtes_anvisa-04-2020-09-09-2021.pdf
Bolsoni-Lopes, A., Furieri, L., & Alonso-Vale, M. (2021). Obesity and covid-19: a reflection on the relationship between pandemics. Revista gaucha de enfermagem, 42(spe), e20200216. https://doi.org/10.1590/1983-1447.2021.20200216 .
Bornstein, S. R., Rubino, F., Khunti, K., Mingrone, G., Hopkins, D., Birkenfeld, A. L., Boehm, B., Amiel, S., Holt, R. I., Skyler, J. S., DeVries, J. H., Renard, E., Eckel, R. H., Zimmet, P., Alberti, K. G., Vidal, J., Geloneze, B., Chan, J. C., Ji, L., & Ludwig, B. (2020). Practical recommendations for the management of diabetes in patients with COVID-19. The lancet. Diabetes & endocrinology, 8(6), 546–550. https://doi.org/10.1016/S2213-8587(20)30152-2 .
Brasil. (2021). Ministério da Saúde. Boletim Epidemiológico Especial: Doença pelo Coronavírus COVID-19. https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/boletins/boletins-epidemiologicos/covid-19/2021/boletim_epidemiologico_covid_52_final2.pdf
Castro, L. A., Roncalli, A. & Camillo, C. A. (2020). Desmanche da ventilação mecânica em pacientes com COVID-19. https://assobrafirciencia.org/article/10.47066/2177-9333.AC20.covid19.017/pdf/assobrafir-11-Suplemento+1-175.pdf
Carvalho, M.F.S. (2017). Deficiência de vitamina D e resistência insulínica em mulheres obesas. Escola Bahiana de Medicina e Saúde Pública (p. 01-62). http://www.repositorio.bahiana.edu.br/jspui/bitstream/bahiana/809/1/Disserta%C3%A7%C3%A3o%20Mestrado%20Minna%20Schleu.pdf
Drucker, D. J. (2020). Coronavirus infections and type 2 diabetes-shared pathways with therapeutic implications. Endocrine Reviews, [s. l.] 41 (3). https://doi.org/10.1210/endrev/bnaa011.
Khunti, K., Del Prato, S., Mathieu, C., Kahn, S. E., Gabbay, R. A., & Buse, J. B. (2021). COVID-19, Hyperglycemia, and New-Onset Diabetes. Diabetes care, 44(12), 2645–2655. https://doi.org/10.2337/dc21-1318.
Lima-Martínez, M. M., Carrera Boada, C., Madera-Silva, M. D., Marín, W., & Contreras, M. (2021). COVID-19 and diabetes: A bidirectional relationship. COVID-19 y diabetes mellitus: una relación bidireccional. Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis, 33(3), 151–157. https://doi.org/10.1016/j.arteri.2020.10.001.
Ministério da saúde. (2020). Protocolo de Manejo Clínico da Covid-19 1a edição revisada. https://bvsms.saude.gov.br/bvs/publicacoes/manejo_clinico_covid-19_atencao_especializada.pdf
Organização Pan-Americana de Saúde. (2020). Alerta Epidemiológico Complicações e sequelas da COVID-19. https://www.paho.org/bra/dmdocuments/covid-19-materiais-de-comunicacao-1/Alerta%20epidemiologico%20-%20Complicacoes%20e%20sequelas%20da%20COVID-19.pdf
Pal, R., & Bhadada, S. K. (2020). COVID-19 and diabetes mellitus: An unholy interaction of two pandemics. Diabetes & metabolic syndrome, 14(4), 513–517. https://doi.org/10.1016/j.dsx.2020.04.049
Pal, R., Bhadada, S. K., & Misra, A. (2021). COVID-19 vaccination in patients with diabetes mellitus: Current concepts, uncertainties and challenges. Diabetes & metabolic syndrome, 15(2), 505–508. https://doi.org/10.1016/j.dsx.2021.02.026.
Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Metodologia da pesquisa científica.
Peric, S., & Stulnig, T. M. (2020). Diabetes and COVID-19: Disease-Management-People. Wiener klinische Wochenschrift, 132(13-14), 356–361. https://doi.org/10.1007/s00508-020-01672-3.
Pranata, R., Henrina, J., Raffaello, W. M., Lawrensia, S., & Huang, I. (2021). Diabetes and COVID-19: The past, the present, and the future. Metabolism: clinical and experimental, 121, 154814. https://doi.org/10.1016/j.metabol.2021.154814.
Sociedade Brasileira de Diabetes. (2020). Notas de esclarecimentos da Sociedade Brasileira de Diabetes sobre o coronavírus (COVID-19). https://diabetes.org.br/covid-19/notas-de-esclarecimentos-da-sociedade-brasileira-de-diabetes-sobre-o-coronavirus-covid-19/#:~:text=N%C3%A3o%20h%C3%A1%20dados%20dispon%C3%ADveis%20com,patologias%20associadas%20e%20em%20idosos.
Sociedade Brasileira de Infectologia. (2020). Atualizações e recomendações sobre a Covid-19. https://infectologia.org.br/wp-content/uploads/2020/12/atualizacoes-e-recomendacoes-covid-19.pdf
World Health Organization (WHO). (2020). Coronavirus disease (COVID-19) pandemic.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Dâmarys Eloir Lima Santos Vieira; Isabella Tavares Souza; Raika Eduarda Rodrigues da Silva; Lauir Souza Gonçalves Netto; Anna Clara Martins de Souza; João Vitor Teixeira Couto; Hígor Chagas Cardoso

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.