Acute Starvation as a Trigger for Non-Diabetic Ketoacidosis in a Third-Trimester Pregnant Woman Undergoing Severe SARS-CoV-2 Pneumonia

Review Data

Q: Is the topic relevant to the journal area of interest? Is it contemporary and interesting for

researchers?

A: Very good

Abstract & Keywords

Q: Are all required components included in the abstract? Are the keywords appropriately chosen?

A: Excellent

Goal

Q: Is the goal explicitly stated in the Introduction? Is its formulation clear and unambiguous?

A: Very good

Structure

Q: Is the paper's structure coherent? Is it in coherence with the goal of the paper?

A: Good

Tools and Methods

Q: Are methods the author uses adequate and well used?

A: Good

Discussion & Conclusion

Q: Is it related to the results presented before? Do you consider them as coherent?

A: Very good

Comments:

The clinical case depicted here demonstrates the relevance of fasting ketoacidemia in a pregnant woman undergoing second to third trimester, without a history of diabetes mellitus. The case description is adequate. The report Discusses that in conditions of increased metabolic demand, such as pregnancy and pneumonia, starving could increase metabolic stress and finally alter the acid-base status affecting the clinical situation for the patient. The Discussion puts forth the rationale for taking up the study, effectively describes the relevant literature and enlists the implications of the findings from the present study in that context.

Literature

Q: Does the author utilize relevant literature?

A: Very good

Author's knowledge

Q: What is the level of the author’s knowledge? Does the author utilize all recent contributions relevant to the topic?

A: Very good

Length

Q: Is the length of the paper adequate to the significance of the topic? Do you suggest shortening the paper without losing its value?

A: Good

Figures & Tables

Q: Does the author use them suitably? Are legend and notations clear?

A: Not applicable

Writing style

Q: Is it clear and understandable?

A: Good

Further comments on the paper

Comments: The case report presents the case of acute starvation as a trigger for non-diabetic ketoacidosis in a 34-years old third-trimester pregnant woman undergoing severe SARS-CoV-2 pneumonia. The study holds significance as starvation ketoacidosis rarely occurs in non-diabetic patients as there are glucose-production pathways compensating for the lack of carbohydrates intake. Till date, there is no such case reported in literature with the SARS-CoV-2 pandemic. The study further states that ketosis is common in prolonged fasting, but it rarely impacts pH in an acute patient.

Q: Would you recommend this manuscript for further publication?

A: Yes - Suitable to be published

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Science Repository Team