Ketoacidosis as a primary manifestation of COVID-19.

INTRODUCTION: Diabetic ketoacidosis is the most important metabolic emergency in children. Children mimic many syndromes with a combination of nonspecific symptoms during the COVID-19 pandemic. Many syndromes are triggered by changes in children's body conditions. Reporting specific cases can improve the diagnosis process. The present study reports an 18-month-old paediatric case of COVID-19 who presented ketoacidosis (DKA) symptoms. CASE PRESENTATION: The case is an 18-month-old child with fever and diarrhoea from 3 days before, who did not respond to outpatient treatment. On the day of the visit, he suffered from deep and abdominal breathing and decreased level of consciousness and sugar levels at admission of 420 mg/dl. He was then admitted with the initial diagnosis of DKA and had a positive PCR test result for COVID-19. CONCLUSIONS: Considering the non-specific symptoms of COVID-19, general practitioners and paediatricians are recommended that special attention be paid to these symptoms, especially those that are similar to life-threatening syndromes. They also should not easily ignore these symptoms and follow up patients and their recovery status and, if patients do not recover, consider the risk of COVID-19 given the current COVID-19 pandemic.

Knowledge, attitude, practice and clinical recommendations of health care workers towards COVID-19: a systematic review.

OBJECTIVES: This study aimed to evaluate the knowledge, attitude, practice, and clinical recommendations of health care workers (HCWs) towards COVID-19. METHODS: In this systematic review study, international databases (Web of Science, PubMed, and Scopus) were searched for the relevant studies published in English from the inception of databases until July 30, 2020. Hoy et al.'s tool was used to evaluate the quality of studies. All search steps, screening, selection of studies, quality assessment, and data extraction were performed separately by two researchers. RESULTS: Out of 3460 articles searched, 28 articles conducted on 16,427 HCWs were included in the study. Most of the HCWs had good knowledge (72.2%), a positive attitude (70.9%), and good practice (78.8%) towards COVID-19. The most important clinical recommendation to improve knowledge, attitude, and practice (KAP) was to provide HCWs with a periodic training program regarding COVID-19. The most important source of information for HCWs on COVID-19 was social networks. CONCLUSIONS: Despite HCWs' good knowledge, attitude, and practice (KAP), it is recommended to periodically review KAP and carry out further studies in different countries as well. It is also recommended to use social media to improve KAP.