CASE REPORT

Coronavirus disease 2019 (COVID-19): A case report in a patient with diabetic ketoacidosis and hypertension

Mauritus Lambertus Edy Parwanto , Reza Aditya Digambiro, Dwi Utomo Nusantara, Twindy Rarasati

Mauritus Lambertus Edy Parwanto
Department of Biology, Faculty of Medicine, Universitas Trisakti, Indonesia. Email: [email protected]

Reza Aditya Digambiro
Department of Anatomical Pathology, Faculty of Medicine, Universitas Trisakti, Indonesia

Dwi Utomo Nusantara
Pasar Minggu Regional General Hospital (RSUD Pasar Minggu), South Jakarta, Indonesia

Twindy Rarasati
Pasar Minggu Regional General Hospital (RSUD Pasar Minggu), South Jakarta, Indonesia
Online First: September 26, 2020 | Cite this Article
Edy Parwanto, M., Digambiro, R., Nusantara, D., Rarasati, T. 2020. Coronavirus disease 2019 (COVID-19): A case report in a patient with diabetic ketoacidosis and hypertension. Bali Medical Journal 9(3): 624-629. DOI:10.15562/bmj.v9i3.1939


Background: Until May 2020, Indonesia is still on COVID-19 emergency status. South Jakarta is part of the Special Capital Region of Jakarta that has applied large-scale social restrictions. The Indonesian government has extended Jakarta's large-scale social restrictions to Friday, May 22nd, 2020 to curb the spread of the corona-virus that causes COVID-19.

Case report: Patients with diabetic ketoacidosis and hypertension were infected with SARS-CoV-2. He had traveled from Saudi Arabia a week before and already has a fever. Arriving in Indonesia, the patient showed symptoms of worsening disease, experienced coughing, shortness of breath, and sore throat. The patient does not inject insulin due to loss of appetite. On March 30th, 2020, a laboratory examination showed high blood sugar levels (369 mg/dL) followed by positive ketones bodies. On April 2nd, 2020, the patient was designated as a confirmed case of COVID-19 after a positive polymerase chain reaction test. The rapid diagnostic test also showed a positive IgM.  Management of patient includes giving O2 through the non-rebreathing oxygen mask, infusion of sodium chloride, 20 IU Apidra®, 12 IU Lantus® injection, Oseltamivir orally, Levofloxacin, Paracetamol, Vitamin C, Candesartan, Concor. This therapy was continued until April 5th, 2020. On April 5th, the patient complained about a cold sensation all over his body. The patient died on the afternoon of April 6th, (8 days of hospitalization) due to sudden cardiac arrest and acute respiratory distress syndrome. Cardiopulmonary resuscitation was done with standardized protocol with no avail.

Conclusion: Diabetic ketoacidosis and hypertension worsen the condition of COVID-19 patients. There are many unknown disease progression outcomes in these patients.

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