Abstract
IntroductionTo assess if in adults with COVID‐19, whether those with diabetes and complications (DM+C) present with a more severe clinical profile and if that relates to increased mortality, compared to those with diabetes with no complications (DM‐NC) and those without diabetes.MethodsService‐level data was used from 996 adults with laboratory confirmed COVID‐19 who presented to the Queen Elizabeth Hospital Birmingham, UK, from March to June 2020. All individuals were categorized into DM+C, DM‐NC, and non‐diabetes groups. Physiological and laboratory measurements in the first 5 days after admission were collated and compared among groups. Cox proportional hazards regression models were used to evaluate associations between diabetes status and the risk of mortality.ResultsAmong the 996 individuals, 104 (10.4%) were DM+C, 295 (29.6%) DM‐NC and 597 (59.9%) non‐diabetes. There were 309 (31.0%) in‐hospital deaths documented, 40 (4.0% of total cohort) were DM+C, 99 (9.9%) DM‐NC and 170 (17.0%) non‐diabetes. Individuals with DM+C were more likely to present with high anion gap/metabolic acidosis, features of renal impairment, and low albumin/lymphocyte count than those with DM‐NC or those without diabetes. There was no significant difference in mortality rates among the groups: compared to individuals without diabetes, the adjusted HRs were 1.39 (95% CI 0.95–2.03, p = 0.093) and 1.18 (95% CI 0.90–1.54, p = 0.226) in DM+C and DM‐C, respectively.ConclusionsThose with COVID‐19 and DM+C presented with a more severe clinical and biochemical profile, but this did not associate with increased mortality in this study.
Highlights
To assess if in adults with COVID-19, whether those with diabetes and complications (DM+C) present with a more severe clinical profile and if that relates to increased mortality, compared to those with diabetes with no complications (DM-NC) and those without diabetes
Those with COVID-19 and diabetes mellitus (DM)+C presented with a more severe clinical and biochemical profile, but this did not associate with increased mortality in this study
The aim of this study is to examine whether DM+C patients with COVID-19 present with more adverse clinical and biochemical profiles and increased mortality compared to people with COVID-19 and DM with no complications (DM-NC) or without DM in an extensively phenotype adult cohort presenting to a large urban UK hospital
Summary
Coronavirus disease 2019 (COVID-19) has impacted on morbidity and mortality of people across the globe. In the non-diabetes, DM-NC and DM+C groups, we looked at the trends of available physiological and laboratory measurements in the first 5 days after admission These included measures of metabolic acidosis and compensation (anion gap, partial pressure of carbon dioxide (pCO2), bicarbonate (HCO3-) and hydrogen ions), indicators of underlying presence of inflammation (serum C-reactive protein, CRP), measures of immune response (lymphocyte count), serum electrolytes and renal function (Na+, K+, urea, estimated glomerular filtration rate, eGFR) and other clinically useful physiological and laboratory measurements (partial pressure of oxygen (pO2), heart rate, temperature and serum albumin). These findings did not reach statistical significance, p-values of 0.093 and 0.226 respectively
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