Objective To analyze the clinical features and management of novel coronavirus pneumonia (COVID-19) patients with diabetic ketoacidosis (DKA) and summarize the experience of clinical diagnosis and treatment.

Methods Clinical data of 3 COVID-19 patients complicated with DKA coma who were rescued and treated in Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from February 10 to 17, 2020 were reported and analyzed.

Results Three patients were recruited in our study, including 1 male and 2 females. Two cases were diagnosed as type 2 and the other was likely to be type 1 diabetes. The random venous blood glucose of all patients were higher than 30 mmol/L and the pH value in blood gas analysis was less than 7.0. One patient had a significantly elevated myocardial enzyme profile, considering as myocarditis. The amylase and lipase of the blood pancreas were significantly increased in one patient, which might indicate that the pancreas was seriously damaged. Inflammatory factors (interleukin, tumor necrosis factor) were significantly increased in 2 patients. Three patients all suffered from coagulation dysfunction. The condition of 3 patients rapidly worsened within 3-4 d after DKA occurred, 2 patients were dead, and 1 patient was transferred to the general ward for further treatment after ICU rescue.

Conclusions During the treatment of COVID-19, triggers should be actively avoided to prevent diabetic ketoacidotic coma. Once DKA occurs, it is often very serious, which would be combined with many organs failure including pancreas, heart, and liver, and leading to adverse prognosis.