Diabetes-associated factors in hospitalized COVID-19 patients with concomitant type 2 diabetes mellitus: focus on mean in-hospital glycemic values

Abstract

Aim of the study: to evaluate the significance of mean glycemic values during hospitalization as a potentially important diabetes-associated risk factor of unfavorable outcomes in inpatients with COVID-19 and type 2 diabetes mellitus (T2DM).Materials and methods. 139 patients with COVID-19 were observed in the hospital, 42 of them had concomitant type 2 diabetes mellitus (DM2). In patients with COVID-19 and type 2 diabetes, the relationship between mean glycemic values during hospitalization and adverse outcomes (death and/or transfer of the patient to the intensive care unit (ICU)) was assessed. The average number of tests to assess glycemia in the hospital was 38.4 ± 15.68 per patient.Results and discussion. According to correlation analysis data, an increase in mean in-hospital glycemia correlated with the severity of lung damage by computed tomography (R = 0.54, p = 0.002), the need for respiratory support by SMRT-CO score (R = 0.29, p = 0.070) and hypercoagulation by the international normalized ratio (R= –0.42, p=0.008). According to regression analysis, predictors of unfavorable outcomes included mean in-hospital glycemia (OR 1.4 [0.93; 2.12], p=0.073) and the percentage of tests with hypoglycemia in the hospital (OR 2.09 [0.89; 5 .40], p=0.016) as well as a history of diabetes (OR 5.5 [0.95, 31.60], p=0.029).Conclusion. Impaired glycemic control during the whole hospitalization period negatively affects disease severity and the risk of adverse outcomes in patients with COVID-19 and type 2 diabetes.