IDF21-0663 Health-Related Quality of Life in Moroccan patients with diabetes after hospitalization for COVID-19

Abstract

Background: Coronavirus disease 2019 (COVID-19) is a world health issue. Chronic diseases such as diabetes stand as among the established potential risk factor for COVID-19. Indeed, mortality and morbidity rate for COVID-19 was higher in this category. COVID-19 and their complications are an unpleasant experience that can cause unprecedented disruption in the well-being of patients with diabetes. Aim: The aim of this study was to evaluate the impact of the COVID-19 on the Health Related Quality of Life (HRQoL) and mental health among Moroccan diabetic patients survivors of COVID-19, and also to determine the demographic and clinical risk factors associated to COVID-19 among patients with diabetes. Method: The study population consisted of 416 diabetic patients. Out of these patients, 158 patients had been discharged from hospital after recovered from COVID-19 and 258 patients had no previous COVID-19 infection (control group). To assess the HRQoL and symptoms of depression and anxiety, the following questionnaires were used: EQ-5D-5L and Hospital Anxiety and Depression Scale (HADS). Results: Data analysis has shown that COVID-19 infection has a negative impact on the HRQoL among diabetic patients. Indeed, patients with diabetes who had recovered from COVID-19 had lower scores of HRQoL (P<0.0001) on both utility (0.18) and VAS (46.42) compared to control group (Utility=0.42; VAS=62.44). The comparison of each EQ-5D-5L dimensions between diabetic patients survivors of COVID-19 versus control group showed that mobility, self-care, usual activities, pain/discomfort, and anxiety/depression dimensions were negatively impacted by COVID-19 (P<0.0001). The results of HADS instrument revealed high level of anxiety and depression symptoms (P<0.05) for diabetic patients recovered of COVID-19 (anxiety = 13.89; depression= 11.79) compared to control group (anxiety = 12.70; depression= 10.85). Concerning the association between socio-demographic/clinical characteristics of patients with diabetes and COVID-19, the results of the binary logistic regression analysis suggested that there was no significant association between gender and COVID-19 (P=0.407). In contrast, patients with diabetes who were older, who were widowed, who had no children, with a primary, secondary or university level education, who were employed, living in urban area, and who had a medium socioeconomic level had higher risk to have COVID-19 (P<0.05). Regarding clinical characteristics, the statistical analysis revealed that patients with diabetes who had other comorbidities especially kidney disease and cardiovascular disease (P<0.0001) had higher risk to have COVID-19 infection compared to those without comorbidities. Discussion: Our survey reported that the COVID-19 infection has a negative impact on diabetic patients’ HRQoL. This result is confirmed also by previous studies. COVID-19 is highly infectious, therefore in order to limit their spread infected patients are isolated that lead to reduce their social interaction. This can affect negatively patients' psychological well-being. The present study shows a high level of anxiety and depression for diabetic patients recovered from COVID-19 compared to control group. The present investigation support policy makers understand the consequences of COVID-19 infection on the diabetic patients’ HRQoL and therefore geared towards post-COVID-19 care and create supportive interventions to restore a good QoL for patients with diabetes.