THU325 Covid-19 Outcomes In Cancer Patients With Diabetes

Abstract

Abstract Disclosure: E.T. Ngo: None. S. Thosani: None. Diabetes mellitus and cancer are risk factors for poor outcomes in patients with Covid-19 (Covid). In this study, we compare Covid outcomes in patients with diabetes and cancer in relation to their inpatient glucose control. We conducted a retrospective review of cancer patients with diabetes hospitalized at our institution from 12/1/2020-7/31/2021 for Covid (n=117). Readmissions were excluded (n=13). Apart from demographic data, other variables reviewed included cancer type, stage, treatment, comorbidities, laboratory data for glucose and inflammatory markers, and Covid-related management. Utilizing average daily glucose for each patient, we calculated percentage of inpatient days with glucose values with euglycemia (average daily glucose within target range of 70-180 mg/dL) and hyperglycemia (average daily glucose values above target of 180 mg/dL). Wilcoxon rank-sum test for contiguous variables and Fisher’s exact test for categorical variables were done to compare the distribution of variables between groups. Kaplan-Meier curve was generated for survival analysis. Of the 104 patients, 73% were age ≥60, 54.8% were male, 49% had BMI >30, and majority (88.5%) were not vaccinated for Covid. 81.7% had type 2 diabetes, 14.4% had drug-induced (i.e. steroid) diabetes, and the remaining had type 1 diabetes. The most common comorbidities were hypertension (56.7%) and heart failure (8.65%). Hematologic malignancies (40.4%) were the prevailing cancer diagnosis. Of patients with cancer staging available (n=50), 33.7% were stage 4, and 66.3% were on active cancer treatment at the time of hospitalization. 49% of the entire cohort had severe Covid on presentation; 21% (n=22) died during hospital stay. Comparison of Covid-related variables and inflammatory markers between euglycemic (n-18) vs. hyperglycemic (n=86) group noted significant differences in LDH, Hba1c and use of steroids which was significantly higher in hyperglycemic group. There was no difference in overall survival (p=0.46) and non-ICU length of stay (p=0.06) noted between groups. Our study confirms high mortality rate from Covid in hospitalized patients with diabetes and cancer. As noted, inpatient glycemic control to achieve targets in this patient population was not associated with reduction in mortality or improvement in Covid-related outcomes, which is in alignment with previously published studies. Presentation: Thursday, June 15, 2023