RECURRENT HYPOGLYCAEMIA IN AN OLDER INDIVIDUAL WITH COVID-19

Authors

  • Tayyabah Usman Aga Khan University Hospital
  • Shahnoor Ahmed
  • Saniya Sabzwari

DOI:

https://doi.org/10.55519/JAMC-04-S4-9656

Abstract

Coronavirus disease caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) emerged as a deadly pandemic overburdening healthcare system globally. While people of all ages were affected, the older population has faced disproportionately higher morbidity and mortality, likely due to altered immune responses and pre-existing comorbid conditions like cardiovascular disease, hypertension, diabetes mellitus, chronic pulmonary and kidney disease. Clinical manifestations in older patients may also be atypical with absence of fever, increased chances of acute confusion and longer recovery times. While other parameters of disease severity have been found, poor glycaemic control is another indicator of severity in COVID 19 infection. Moreover, older patients with diabetes mellitus are also at risk of hypoglycaemia which increases the risk of cardiovascular and cerebrovascular events, progression of dementia, falls, emergency department visits and hospitalization. Here we share a case of an older man with COVID-19 infection who presented primarily with recurrent hypoglycaemia and weakness. This case also highlights the social impact of an infection that has decimated support systems for vulnerable older adults.  

References

Kamran SM, Mirza ZE, Moeed HA, Naseem A, Hussain M, Fazal I Sr, et al. CALL Score and RAS Score as Predictive Models for Coronavirus Disease 2019. Cureus 2020;12(11):e11368.

Gan JM, Kho J, Akhunbay-Fudge M, Choo HM, Wright M, Batt F, et al. Atypical presentation of COVID-19 in hospitalised older adults. Ir J Med Sci 2021;190(2):469–74.

Ward CF, Figiel GS, McDonald WM. Altered Mental Status as a Novel Initial Clinical Presentation for COVID-19 Infection in the Elderly. Am J Geriatr Psychiatry 2020;28(8):808–11.

Parveen R, Sehar N, Bajpai R, Agarwal NB. Association of diabetes and hypertension with disease severity in covid-19 patients: A systematic literature review and exploratory meta-analysis. Diabetes Res Clin Pract 2020;166:108295.

Scheen AJ. Pharmacokinetic considerations for the treatment of diabetes in patients with chronic kidney disease. Expert Opin Drug Metab Toxicol 2013;9(5):529–50.

Shauly-Aharonov M, Shafrir A, Paltiel O, Calderon-Margalit R, Safadi R, Bicher R,et al. Both high and low pre-infection glucose levels associated with increased risk for severe COVID-19: New insights from a population-based study. PLoS One 2021;16(7):e0254847.

Published

2022-10-11