ArticleBMJ case reports2021
Severe metabolic ketoacidosis as a primary manifestation of SARS-CoV-2 infection in non-diabetic pregnancy.
Article in BMJ case reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 15 citations in OpenAlex.
- Metabolic acidosis with elevated anion gap and euglycemic ketoacidosis in pregnant and postpartum women with severe Covid-19.Annals of medicine · 2025Observational
- Treatment and Outcomes of COVID-19 Infection in Pregnant Women: Systematic Review of Cases Reported in Europe.Journal of clinical medicine · 2025Review
- Euglycemic diabetic ketoacidosis and COVID-19 management in a term pregnant patient; a case report.Clinical case reports · 2022Article
- Euglycemic diabetic ketoacidosis and COVID-19: A combination to foresee in pregnancy.Journal of diabetes · 2022Article
- Starvation ketosis in a pregnant woman with COVID-19: a case report.Endocrinology, diabetes & metabolism case reports · 2022Article
- Diabetic ketoacidosis in patients with SARS-CoV-2: a systematic review and meta-analysis.Diabetology & metabolic syndrome · 2021Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We present a case of a metabolic acidosis in a term-pregnant woman with SARS-CoV-2 infection.Our patient presented with dyspnoea, tachypnoea, thoracic pain and a 2-day history of vomiting, initially attributed to COVID-19 pneumonia. Differential diagnosis was expanded when arterial blood gas showed a high anion gap metabolic non-lactate acidosis without hypoxaemia. Most likely, the hypermetabolic state of pregnancy, in combination with maternal starvation and increased metabolic demand due to infection, had resulted in metabolic ketoacidosis. Despite supportive treatment and rapid induction of labour, maternal deterioration and fetal distress during labour necessitated an emergency caesarean section. The patient delivered a healthy neonate. Postpartum, after initial improvement in metabolic acidosis, viral and bacterial pneumonia with subsequent significant respiratory compromise were successfully managed with oxygen supplementation and corticosteroids. This case illustrates how the metabolic demands of pregnancy can result in an uncommon presentation of COVID-19.
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