COVID-19

Background: The COVID-19 pandemic has been associated with various complications and has altered patterns of disease presentation. COVID-19 is known to affect the immune system. We report a case of disseminated tuberculosis (TB) in a previously non-immunocompromised patient with a history of COVID-19 infection. Case Presentation: A 25-year-old woman with a history of mild COVID-19 infection three months earlier developed progressive back pain followed by worsening headache. She was eventually admitted with decreased level of consciousness, delirium, and focal neurological deficits. Further evaluation confirmed disseminated tuberculosis, including miliary pulmonary TB, TB meningitis, and TB spondylodiscitis. The patient showed gradual clinical and neurological improvement following anti-tuberculosis therapy. Conclusions: This case suggests a possible association between COVID-19 infection and subsequent development of disseminated tuberculosis, even in immunocompetent individuals.

INTRODUCTION: The coronavirus 2019 (COVID-19) pandemic has represented a major global health emergency and It is now recognized as a multisystemic disease, with potential repercussions on various organs. Diabetes mellitus is a common comorbidity associated with COVID-19. Its first-time diagnosis during the course of COVID-19 infection has been frequently reported, often with specific clinical, biological, and prognostic profiles. A better understanding of this association could shed light on the interplay between these two conditions. PATIENTS AND METHODS : This retrospective, descriptive, and analytical study included non-diabetic patients hospitalized for COVID-19 between 2021 and 2022 in the Pulmonology Department of the University Hospital of Sfax. Patients who developed newly diagnosed diabetes during hospitalization were identified and formed the basis of our analysis. RESULTS: New-onset diabetes was identified in 108 patients (12.9%) during hospitalization for COVID-19 with a mean age of 64.4 years and a male-to-female ratio of 1.34. Hypertension was the most common associated comorbidity, reported in 35.2% of cases. Clinically, the most frequent symptoms were dyspnea (60%), fever (55.6%), and cough (52.8%). On physical examination, hypoxia was observed in 65% of patients at admission. Laboratory findings revealed a mean random blood glucose level of 14.8 mmol/L. Chest CT scans showed extensive pulmonary involvement in 58% of cases. Systemic corticosteroids were prescribed in 70.6%. Diabetic ketoacidosis occurred in 4.6% of cases. Nine percent of patients with newly diagnosed diabetes required transfer to an intensive care unit. The mortality rate in this group was 14.7%. At a mean follow-up of 24 months, glycemic status was reassessed. Among reachable patients, 60% remained diabetic. Diarrhea and the severity of radiological lung involvement were identified as independent predictors of new-onset diabetes during COVID-19 infection. CONCLUSION: New-onset diabetes during COVID-19 infection is not uncommon. It is associated with distinct clinical and paraclinical features. Early identification of diabetes in this context is essential for timely and appropriate management to prevent complications.