Endocrine Abstracts

A major cause of morbidity is post COVID-19 complications. The symptoms of carbohydrate dysfunction can be due to has relationship with coronavirus disease. In patients with chronic disorders after SARS-CoV-2 infection, aggravation of pre-existing symptoms has also been noticed. Diabetes insipidus (DI) may be at risk of dysnatraemia when developing respiratory complications of COVID-19. Particularly, the combination of two or more concurrent disorder is a major problem in patient treatment. Especially when one of the diseases is a predictor of another. This not only complicates the diagnosis but also prolongs the duration of treatment, sometimes complicating an algorithm of management and reduces its effectiveness. Thus considering the above mentioned facts, we would like to focus your attention on such comorbidities as post COVID-19 complication: diabetes melletus (DM) in patient with DI, and give a sense of this problem on the basis of clinical case study. A 69-year-old female with a past medical history of DI diagnosed five years ago treated with nasal spray desmopressin (10 μg intranasal twice daily) after COVID-19 pneumonia who later manifested DM. She was diagnosed with COVID-19 infection with nasopharyngeal reverse transcriptase polymerase reaction (RT-PCR) at an outpatient clinic 60 days ago. IgG against SARS-CoV-2 was positive. After two month for the treatment of COVID-19 pneumonia the patient complaining of polydipsia, polyuria and nocturia during the previous month. Laboratory examinations showed abnormally increased blood sodium (serum sodium -156 mmol/l) and chloride (serum chloride – 115 mmol/l) and decreased urine osmolality and specific gravity of 1.006. Thyroid function tests were normal. The level of glycosylated hemoglobin (HbA<ce:inf>1</ce:inf>C) was 7.0%, blood sugar levels ranged from 7.6 to 19.0 mmol/l. After additional examination the patient with DI was diagnosed with DM. The patient was prescribed treatment with metformin at a daily dose of 1500 mg during the meal to correct carbohydrate metabolism and added doses of desmopressin (20 μg intranasal twice daily). After 3 months, the therapy resulted in patient’s improvement of the general conditions and compensation of DM was achieved: no episodes of hypoglycemia were recorded; the HbA1C level was 6.4%; glycemia levels ranged from 5.4 to 8.0 mmol/l; and normalization of electrolytic metabolism.

Conclusions: Further studies are needed to clarify the link between COVID-19 and DM in patient with DI, to provide the optimal management.