(259) Demographic and Clinical Characteristics of Children With DKA During and Before COVID-19 Pandemic

Introduction: There are multiple reports on the rise of diabetic ketoacidosis (DKA) admissions during the COVID-19 pandemic, yet data regarding demographic variations remains sparse. We aimed to compare single institutional data for demographic and clinical variables among children admitted with DKA during and before the COVID-19 pandemic.

Methods: After IRB approval, all children admitted with DKA from 2012 to 2022 were retrieved from the hospital database. For this study purpose, the pandemic period was defined between 2020-2022 and the pre-pandemic period as 2012-2019. The prevalence of DKA admissions was calculated per 100 total PICU admissions. Race, ethnicity, gender, age (months), proportion of new-onset diabetes, and length of hospital stay were compared between the two periods. Chi-square and Mann-Whitney-U tests were employed for inferential statistics. Categorical data are presented as odds ratio (OR) with 95% CI. Continuous data are presented as median (IQR).

Results: Out of a total of 983 admissions with DKA during the study period, 392 (39.9%) were new-onset. The prevalence of DKA admissions was 6.24% during the pandemic vs 4.18% during the pre-pandemic period (OR:1.53; 1.32-1.70). The median age was 13.5 (9.9-16.4) years and consisted of 57.6% females with no significant differences between the two periods. The proportion of new-onset diabetes was lower during the pandemic period (27.8% vs 47.1%; OR: 0.43; 0.33-0.57). The proportion of white children was lower (68.7% vs 79.9%; OR: 0.55; 0.41-0.74), black children was higher (19.1% vs 13.3%; OR: 1.54; 1.08-2.18), and Hispanic children was similar (74.6% vs 77.2%) during the pandemic period. The median length of hospital stay was 2 (2-3) days with no difference between the two periods.

Conclusions: The COVID-19 pandemic has seen a rise in the prevalence of DKA among hospitalized children, particularly those with pre-existing diabetes. Notably, there has been a disproportionate increase in black children with DKA during this period. One of the plausible reasons contributing to this disparity is the potential racial difference in access to healthcare during the pandemic. The findings have significant implications for public healthcare policies.