Abstract
Introduction: As diabetes is highly prevalent worldwide, understanding particular dimensions of COVID-19 infection in diabetic patients is of significant importance. Objectives: The present research aimed to evaluate the outcome of diabetic patients with COVID-19 infection, and the clinical and biochemical characteristics in survived and non-survived patients. Patients and Methods: The present single-center, cross-sectional study examined laboratory and clinical features of 160 patients with diabetes who had moderate to severe criteria. The obtained data were categorized as survived or non-survived patients and then we compared the clinical characteristics in two groups. Results: In this study, 160 diabetic patients (75 men and 85 women) admitted with moderate to severe Covid-19 were evaluated. The mean age of studied patients was 51-90 years old, with diabetes duration of 5 to 15 years. One hundred thirty-one patients (81.9%) survived, but twenty-nine patients (18.1%) did not survive. Regarding the comparison of symptoms, only the loss of consciousness on admission was higher in non- survived patients; however, a majority of the non-survivors have been admitted to ICU, 23(79.3%) and 26 (89.6%) needed invasive mechanical ventilation; in comparison to survived patients also had a shorter duration of hospital stay (5.5±5.1 versus 8.4±6.1days). Non–survivors more probably suffer from high blood pressure [23 (79.3%) patients versus 80 (61%) patients] and chronic kidney disease [20 (69%) patients versus 9 (6.9%) patients; P<0.001]. Glycated hemoglobin (HbA1c) of more than 9%, and high fasting blood sugar, severe inflammatory response, hepatic, renal, and coagulation impairment was higher in non–survived than those who survived. Conclusion: Multifactorial parameters result in the poor prognosis in diabetic patients; therefore, it is critical for identifying the key clinical, as well as laboratory characteristics of COVID-19 cases that lead to severe disease and increase the risk of death.
Highlights
As diabetes is highly prevalent worldwide, understanding particular dimensions of COVID-19 infection in diabetic patients is of significant importance
In our cross-sectional study on 160 diabetic patients admitted with moderate to severe COVID-19 infection, we found poor controlled diabetes, concurrent hypertension and chronic kidney disease were associated with severe COVID-19 infection and increase the risk of death
The clinical course of COVID-19 infection in diabetic patients varies with the milder symptoms that occur at the first stage; Davoudi et al they face the increased risks of fast progression to severe pneumonia, uncontrolled cytokine storm, as well as the hypercoagulable state that involves in the poorer prognosis of the disease [7]
Summary
As diabetes is highly prevalent worldwide, understanding particular dimensions of COVID-19 infection in diabetic patients is of significant importance. Conclusion: Multifactorial parameters result in the poor prognosis in diabetic patients; it is critical for identifying the key clinical, as well as laboratory characteristics of COVID-19 cases that lead to severe disease and increase the risk of death. In our cross-sectional study on 160 diabetic patients admitted with moderate to severe COVID-19 infection, we found poor controlled diabetes, concurrent hypertension and chronic kidney disease were associated with severe COVID-19 infection and increase the risk of death. The clinical course of COVID-19 infection in diabetic patients varies with the milder symptoms that occur at the first stage; Davoudi et al they face the increased risks of fast progression to severe pneumonia, uncontrolled cytokine storm, as well as the hypercoagulable state that involves in the poorer prognosis of the disease [7]
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