Treatment of Covid-19 in a pre-diabetic patient in the intensive care unit: a case report

Authors

DOI:

https://doi.org/10.33448/rsd-v11i7.30146

Keywords:

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.

Published

04/06/2022

How to Cite

VIEIRA, D. E. L. S. .; SOUZA, I. T.; SILVA, R. E. R. da; GONÇALVES NETTO, L. S.; SOUZA, A. C. M. de; COUTO, J. V. T.; CARDOSO, H. C. . Treatment of Covid-19 in a pre-diabetic patient in the intensive care unit: a case report. Research, Society and Development, [S. l.], v. 11, n. 7, p. e56011730146, 2022. DOI: 10.33448/rsd-v11i7.30146. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/30146. Acesso em: 24 apr. 2024.

Issue

Section

Health Sciences