Clinical characteristics and outcomes of COVID-19 patients with diabetes mellitus in Kuwait

Abdullah Alshukry,Mohammad Bu Abbas,Yaseen Ali,Barrak Alahmad,Abdullah A Al-Shammari,Ghadeer Alhamar,Mohammad Abu-Farha,Jehad Abubaker,Sriraman Devarajan,Ali A Dashti,Fahd Al-Mulla,Hamad Ali

doi:10.1016/j.heliyon.2021.e06706

Abstract

BackgroundCOVID-19 has a highly variable clinical presentation, ranging from asymptomatic to severe respiratory symptoms and death. Diabetes seems to be one of the main comorbidities contributing to a worse COVID-19 outcome. ObjectiveIn here we analyze the clinical characteristics and outcomes of diabetic COVID-19 patients Kuwait. MethodsIn this single-center, retrospective study of 417 consecutive COVID-19 patients, we analyze and compare disease severity, outcome, associated complications, and clinical laboratory findings between diabetic and non-diabetic COVID-19 patients. ResultsCOVID-19 patients with diabetes had more ICU admission than non-diabetic COVID-19 patients (42.4% vs. 7.7%, p < 0.001). Diabetic COVID-19 patients also recorded higher mortality in comparison to non-diabetic COVID-19 patients (34.7% vs. 3.7%, p < 0.001). Diabetic COVID-19 patients had significantly higher prevalence of comorbidities, such as hypertension. Laboratory investigations also highlighted notably higher levels of C-reactive protein in diabetic COVID019 patients and lower estimated glomerular filtration rate. They also showed a higher incidence of complications. logistic regression analysis showed that every 1 mmol/L increase in fasting blood glucose in COVID-19 patients is associated with 1.52 (95% CI: 1.34–1.72, p < 0.001) times the odds of dying from COVID-19. ConclusionDiabetes is a major contributor to worsening outcomes in COVID-19 patients. Understanding the pathophysiology underlining these findings could provide insight into better management and improved outcome of such cases.

Highlights

In December 2019, a novel coronavirus, known as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), emerged in Wuhan, China [1,2,3]
Coronavirus Disease 2019 (COVID-19), the disease caused by the virus, has shown a highly variable clinical presentation, ranging from asymptomatic to severe illness leading to death
We investigated the relationship between fasting blood glucose as a continuous exposure and intensive care unit (ICU) admission as an outcome from COVID-19 as a binary response and adjusted to other covariates

Summary

Introduction

In December 2019, a novel coronavirus, known as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), emerged in Wuhan, China [1,2,3] Since it has spread rapidly all over the world and was declared a pandemic by the World Health Organization on March 11, 2020. Methods: In this single-center, retrospective study of 417 consecutive COVID-19 patients, we analyze and compare disease severity, outcome, associated complications, and clinical laboratory findings between diabetic and nondiabetic COVID-19 patients. Laboratory investigations highlighted notably higher levels of C-reactive protein in diabetic COVID019 patients and lower estimated glomerular filtration rate. They showed a higher incidence of complications. Understanding the pathophysiology underlining these findings could provide insight into better management and improved outcome of such cases

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Conclusion