Introduction Data of COVID-19 in newborns and children are limited, and clinical manifestations are nonspecific and might delay the diagnosis, which might lead to severe complications. In this clinical case, we will describe new-onset diabetes with consciousness impairment as an atypical revealing way of COVID-19. Case A 3-year-old child presented to the Emergency Department with loss of consciousness (without fever), lethargy, and stupor. Clinical assessment on admission found an unconscious child with a pediatric Glasgow Coma Scale of 10/15 with no localizing signs or meningeal syndrome, polypneic of 35 breaths/min, pulse oximetry of 90%, with signs of overall dehydration: skin folds, sunken eyes, tachycardia of 160 beats/minute, and recoloring time superior at 3 seconds. Laboratory findings showed hyperleukocytosis of 16000/mm 3 , lymphopenia of 450/mm 3 , glycemia of 5 g/L with a correct ionogram : corrected natremia of 139 mmol/L, serum potassium of 4.5 mmol/L, glycosuria of 3+, ketonuria of 2+, and HbA1c of 10%, and COVID-19 RT-PCR came back positive. Conclusion COVID-19 might be revealed with atypical symptoms including new-onset diabetes and diabetic ketoacidosis; therefore, clinicians must suspect it in children with blood glucose and HbA1c at the time of admission. This will help to manage patients with hyperglycemia early.
【초록키워드】 COVID-19, pulse oximetry, pediatric, children, Diagnosis, RT-PCR, lymphopenia, serum, Newborn, Fever, Patient, Potassium, scale, hyperglycemia, Admission, blood glucose, Emergency, Atypical, clinical manifestation, clinical assessment, Diabetic, Loss of consciousness, Tachycardia, clinician, lethargy, syndrome, help, severe complications, eyes, Department, impairment, positive, glycemia, ketonuria, diabete, atypical symptom, natremia, nonspecific, skin folds, unconscious, 【제목키워드】 clinical, report,