Background
In December 2019, a novel coronavirus later named Covid-19 appeared in Wuhan, China and quickly developed into a worldwide pandemic (1).
Covid-19 can have significant effects on pregnancy and a pregnant woman with this infection may have symptoms such as shortness of breath, fatigue, and lethargy. Pregnant women are at higher risk for developing ketosis, and concomitant infections may lower the metabolic threshold at which ketoacidosis happen (2).
Certain hormones production during pregnancy such as progesterone, cortisol and prolactin can increase the risk of ketoacidosis by boosting insulin resistance (3). Blood glucose level less than 200 mg/dL, increased anion gap metabolic acidosis, and ketonemia are the biochemical triad for euglycemic diabetic ketoacidosis (Dka) (4).
In this case report, we report a Covid-19 infected pregnant woman with primary manifestation of ketoacidosis at term pregnancy and discuss the management challenges with euglycemia and a high ketone burden.