RESUMEN
During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, coronavirus disease 2019 (COVID-19) has been significantly studied for its relationship with diabetes mellitus in general. Still, the association of SARS-CoV-2 infection with diabetic ketoacidosis (DKA) is more specific and warrants a meticulous investigational approach. In this case report, we present a 23-year-old female who developed DKA as the first manifestation of SARS-CoV-2 infection. During hospitalization, the diagnosis of type 1 diabetes mellitus (T1DM) was made and the patient was treated successfully for the metabolic disorder and for SARS-CoV-2. The potential of SARS-CoV-2 to induce DKA in type 1 diabetics is highlighted. We point out that DKA and COVID-19 may have similarities in clinical presentation when gastrointestinal features predominate. In addition, we describe mechanisms that have been hypothesized to explain the negative impact of SARS-CoV-2 on the endocrine pancreatic function.
RESUMEN
BACKGROUND: Recent findings associate asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) with the prognosis of acute myocardial infarction (AMI). The purpose of the current study was to associate patients' lifestyle, sociodemographic, and somatometric characteristics with the time course of ADMA and SDMA concentrations in the serum of AMI patients. PATIENTS AND METHODS: In the serum of 66 AMI patients, ADMA, SDMA, troponin T, and C-reactive protein (CRP) were measured upon hospital admission (<24 h) and on the 3rd day following. Lifestyle, sociodemographic, and somatometric characteristics were obtained through a questionnaire, filled on patient discharge. RESULTS: ADMA concentrations on the 1st day positively correlated with daily reported hours of sleep (+0.497, P < 0.001) and delivery or eating out frequency (+0.285, P = 0.02), whereas it negatively correlated with reported physical condition (-0.304, P = 0.013). A personal history of hypertension indicated higher 1st-day ADMA concentration (1.818 vs 1.568, P = 0.042). Age positively correlated with 1st-day SDMA (+0.320, P = 0.009). All of the biomarker concentrations were reduced on the 3rd day measurements (P < 0.001). Self-reported lifetime minimum BMI positively correlated with either absolute (r = +0.366, P = 0.009) or percentage (r = +0.262, P = 0.045) ADMA reduction. A daily sleep in 5-8-h range was inversely correlated with percentage (-0.410, P = 0.001) or absolute (r = -0.369, P = 0.002) SDMA reduction. CONCLUSIONS: Modifiable factors such as BMI, eating habits, physical condition, and sleep seem to affect the baseline levels or time course of ADMA and SDMA in AMI patients. Changes in these factors may affect AMI prognosis by altering dimethylarginine levels.
