Abstract
Objectives This study screened for factors affecting coronavirus disease 2019 (COVID-19) incidence in type 1 diabetes mellitus (T1DM) patients, appraised vitamin D's efficacy in preventing COVID-19, and assessed the effects of clinical characteristics, glycemic status, vitamin D, and hydroxychloroquine administration on COVID-19's progression and severity in T1DM patients. Methods This retrospective research on 150 adults was conducted at Security Forces Hospital, Riyadh, KSA. Participants were allocated to three groups (50/group): control, T1DM, and T1DM with COVID-19. Participants' fasting blood glucose (FBG), glycated hemoglobin (HbA1c), complete blood count, vitamin D, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), ferritin, lactate dehydrogenase (LDH), prothrombin time, activated partial thromboplastin time, D-dimer, liver and kidney function, and hydroxychloroquine treatment were retrieved and analyzed. Results The percentages of comorbidities and not taking hydroxychloroquine were significantly higher among T1DM patients with COVID-19 than patients with T1DM only. Mean vitamin D level was significantly lower in T1DM with COVID-19 patients than in the other two groups. Vitamin D showed a significant negative correlation with LDH, CRP, ESR, ferritin, and D-dimer, which was the most reliable predictor of COVID-19 severity in T1DM patients. Conclusion Comorbidities and vitamin D deficiency are risk factors for COVID-19 in patients with T1DM. Patients who do not take hydroxychloroquine and have higher FBG and HbA1c levels are vulnerable to COVID-19. Vitamin D may be useful for preventing COVID-19 in T1DM patients. Comorbidities, higher FBG and HbA1c levels, not taking hydroxychloroquine, and vitamin D inadequacy elevate COVID-19 progression and severity in patients with T1DM.
Highlights
Type 1 diabetes mellitus (T1DM) is a mutual endocrine and metabolic condition that is widespread globally, with a continuously rising incidence of about 3% yearly [1, 2]
T1DM patients are fully dependent on exogenous insulin, and vitamin D may be used to reduce the insulin dose
Diabetes is the most critical of the comorbidities, increasing the severity of COVID-19, which is attributed to the disruption of innate cellular immunity in T1DM patients [9, 10]
Summary
Type 1 diabetes mellitus (T1DM) is a mutual endocrine and metabolic condition that is widespread globally, with a continuously rising incidence of about 3% yearly [1, 2]. In January 2020, the World Health Organization announced that the coronavirus disease 2019 (COVID-19) outbreak was a public health emergency [6]. This new betacoronavirus (SARS-CoV-2) is related to severe acute respiratory syndrome coronavirus (SARSCoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) because of their genetic similarities [7]. The risk factors for COVID-19 are diabetes, hypertension, and cardiovascular and respiratory diseases [8]. Diabetes is the most critical of the comorbidities, increasing the severity of COVID-19, which is attributed to the disruption of innate cellular immunity in T1DM patients [9, 10]
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