{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T16:19:49Z","timestamp":1785428389109,"version":"3.56.0"},"reference-count":19,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T00:00:00Z","timestamp":1752192000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background: This study aimed to describe the clinical features and severity of illness in patients diagnosed with both coronavirus disease 2019 (COVID-19) and diabetic ketoacidosis (DKA) at a South African regional hospital.\n\nMethods: This was a single centre, retrospective, observational study conducted at a regional hospital in Johannesburg, South Africa. Records of patients who presented to the emergency department (ED) between 01 April 2020 to 31 August 2021 and were diagnosed with DKA were reviewed. Both COVID-19 positive and negative patients were included.\n\nResults: Of the 104 patients with DKA, 35 (33.7%) tested positive for COVID-19. Among the COVID-19 positive group, two required ICU admission and two were admitted to the High Care Unit (HCU). Interventions included high-flow nasal cannula (1 patient), intubation (2 patients), and inotropic support (1 patient). Outcomes included one death (2.9%), one patient declining treatment, and one transfer. A statistically significant association was found bet<\/jats:p>","DOI":"10.4102\/jcmsa.v3i1.142","type":"journal-article","created":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T07:51:36Z","timestamp":1752220296000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diabetic Ketoacidosis and COVID-19: Patient profiles from a regional emergency department in Johannesburg, South Africa"],"prefix":"10.4102","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8220-9630","authenticated-orcid":false,"given":"Hanlie","family":"Dreyer","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rp50x72","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Witwatersrand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1138-4978","authenticated-orcid":false,"given":"Pravani","family":"Moodley","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rp50x72","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Witwatersrand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2736-2872","authenticated-orcid":false,"given":"Robert","family":"Kieser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2025,7,11]]},"reference":[{"key":"ref0","unstructured":"World Health Organization. Coronavirus disease (COVID-19) pandemic [homepage on the Internet]. World Health Organization; 2023 [cited 2024 Aug 11]. Available from: https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019"},{"key":"ref1","unstructured":"National Institute for Communicable Diseases (NICD): Division of the National Health Laboratory Service. All you need to know about COVID-19. [homepage on the Internet]. 2025 [cited 11 August 2024]. Available from: https:\/\/www.nicd.ac.za\/diseases-a-z-index\/disease-index-covid-19\/"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Bornstein SR, Zimmet P, Rubino F, Ludwig B. Management of diabetes in patients with COVID-19 \u2013 Authors\u2019 reply. Lancet Diabetes Endocrinol. 2020;8(8):669\u2013670. https:\/\/doi.org\/10.1016\/S2213-8587(20)30223-0","DOI":"10.1016\/S2213-8587(20)30223-0"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Roncon L, Zuin M, Rigatelli G, Zuliani G. Diabetic patients with COVID-19 infection are at higher risk of ICU admission and poor short-term outcome. J Clin Virol. 2020;127:104354.","DOI":"10.1016\/j.jcv.2020.104354"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Unnikrishnan R, Misra A. Diabetes and COVID19: A bidirectional relationship. Nutr Diabetes. 2021;11(1):1\u20135.","DOI":"10.1038\/s41387-021-00163-2"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Rubino F, Amiel SA, Zimmet P, et al. New-onset diabetes in COVID- 19. N Engl J Med. 2020;383:789\u2013790.","DOI":"10.1056\/NEJMc2018688"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Kazakou P, Lambadiari V, Ikonomidis I, et al. Diabetes and COVID-19; A Bidirectional Interplay. Front Endocrinol (Lausanne). 2022;13:780663.","DOI":"10.3389\/fendo.2022.780663"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Patel U, Deluxe L, Salama C, et al. 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