Some patients go in for COVID-19, others are infected alongside another issue. In hospitals, those lines blur

Inside a busy intensive care unit in Toronto’s east end, Dr. Martin Betts often sees patients grappling with a double diagnosis: a serious health issue coupled with — or caused by — COVID-19.

As chief of critical care for the Scarborough Health Network, Betts has treated several patients with diabetic ketoacidosis, a build-up of acids in the blood that’s a life-threatening complication of diabetes, which can be triggered by viral infections.

Other people have been admitted for heart inflammation, heart attacks and even cardiac arrest caused by a SARS-CoV-2 infection — yet COVID-19 is often listed as a secondary diagnosis, a situation Betts describes as “misleading.”

“Incidental COVID