Clinical characteristics and outcomes of hospitalized COVID-19 patients with diabetes: A multi-center, retrospective study in Turkey

Fatih Türker; Süleyman Ahbab; Betül Çavuşoğlu Türker; Esra Ataoğlu; Savaş Öztürk

doi:10.7197/cmj.1017675

EN

Clinical characteristics and outcomes of hospitalized COVID-19 patients with diabetes: A multi-center, retrospective study in Turkey

Abstract

Objective: Diabetes mellitus is known as one of the potential risk factors for severe COVID-19.This study it was aimed to evaluate and compared demographic, clinical and laboratory findings,mortality and outcomes of hospitalized diabetic and non-diabetic COVID-19 patients.

Method: The data of all consecutive adult patients admitted to the pandemic units of the participating hospitals’ internal medicine clinics with the diagnosis of Covid-19 disease were gathered between April 20th 2020 and July 23th 2020.Only swab or serological tests positive patients were included in the study.Patients with clinical and/or radiological findings were considered to have Covid-19 disease and those having negative swab tests were excluded.The clinical characteristics, treatment and discharge outcomes and laboratuary tests of the patients at presentation were divided into two groups and compared as diabetic and non-diabetic COVID-19 patients.

Results: The median age was 52 years.There were 226 diabetic (21.2 %) and 839 (78.8%) non-diabetic patients.Diabetic patients were older than nondiabetics . Chronic diseases in the group of diabetic patients were found to be significantly higher than non-diabetic patient group (p<0,001).There was no significant difference in major symptoms such as dry cough,fatigue fever between two groups.Percentage of anorexia was significantly elevated in the diabetic group (p<0,001).In diabetic group,baseline (at the time of diagnoses) serum eGFR,hemoglobin levels were decreased and sedimentation,CRP,procalcitonin,D-dimer were elevated than nondiabetic group (p<0,001,p=0,009,p:<0.001,p<0.001,p<0.001,p=0.029 respectively). Admission to the intensive care unit and mortality were increased in diabetic patients group.(p<0.001)

Conclusions: Diabetes are associated with increased complications, prolonged hospital stay, and mortality in COVID-19 patients.

Keywords

References

1. Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet 2020;395(10223): 470–3. https://doi.org/10.1016/S0140-6736(20)30185-9.
2. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497–506. https://doi.org/10.1016/S0140-6736(20)30183-5.
3. Garg S, Kim L, Whitaker M, O’Halloran A, Cummings C, Holstein R, et al. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019—COVID-NET, 14 States, March 1–30, 2020. MMWR Morb Mortal Wkly Rep 2020;69(15):458–64. https://doi.org/10.15585/mmwr.mm6915e3.
4. Kobayashi T, Jung S, Linton NM, Kinoshita R, Hayashi K, Miyama T, et al. Communicating the risk of death from novel coronavirus disease (COVID-19). J Clin Med 2020;9(2):580. https://doi.org/10.3390/jcm9020580
5.Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA 2020;323(20):2052–9. https://doi.org/10.1001/jama.2020.6775..
6. Yang J, Zheng Y, Gou X, et al. Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis. Int J Infect Dis 2020; pii: S1201-9712(20)30136-3.
7. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. (2020) 395:497–506. doi: 10.1016/S0140-6736(20)30183-5
8. Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. (2020) 382:1708–20. doi: 10.1056/NEJMoa2002032

9. Yang X, Yu Y, Xu J, Shu H, Xia Ja, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475-81.
10 Zhang J-j, Dong X, Cao Y-y, Yuan Y-d, Yang Y-b, Yan Y-q, et al. Clinical characteristics of 140 patients infected with SARS‐CoV‐2 in Wuhan, China. Allergy. 2020
11. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020;395(10223):507-13.
12. Hsia CCW, Raskin P. The diabetic lung: Relevance of alveolar microangiopathy for the use of inhaled insulin. The American Journal of Medicine. 2005;118(3):205-11.
13. Goldman MD. Lung Dysfunction in Diabetes. Diabetes Care. 2003;26(6):1915-8.
14. Kiselar JG, Wang X, Dubyak GR, El Sanadi C, Ghosh SK, Lundberg K, et al. Modification of β-Defensin-2 by Dicarbonyls Methylglyoxal and Glyoxal Inhibits Antibacterial and Chemotactic Function In Vitro. PLOS ONE. 2015;10(8):e0130533.
15. Knapp S. Diabetes and infection: is there a link?--A mini-review. Gerontology. 2013;59(2):99-104.
16.ONAT, Altan, et al. "Türkiye'de Erişkinlerde Kalp Hastalığı ve Risk Faktörleri Sıklığı Taraması: 6. Diyabet ve Obesite." Türk Kardiyoloji Derneği Arşivi 19.3 (1991): 178-185.
17. Kumar A, Arora A, Sharma P, Anikhindi SA, Bansal N, Singla V, Khare S, Srivastava A. Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis. Diabetes Metab Syndr. 2020 Jul-Aug;14(4):535-545. doi: 10.1016/j.dsx.2020.04.044. Epub 2020 May 6. PMID: 32408118; PMCID: PMC7200339
18. Raghavan S, Vassy JL, Ho YL, Song RJ, Gagnon DR, Cho K, Wilson PWF, Phillips LS. Diabetes Mellitus-Related All-Cause and Cardiovascular Mortality in a National Cohort of Adults. J Am Heart Assoc. 2019 Feb 19;8(4):e011295. doi: 10.1161/JAHA.118.011295. PMID: 30776949; PMCID: PMC6405678.
19. Berbudi A, Rahmadika N, Tjahjadi AI, Ruslami R. Type 2 Diabetes and its Impact on the Immune System. Curr Diabetes Rev. 2020;16(5):442-449. doi: 10.2174/1573399815666191024085838. PMID: 31657690; PMCID: PMC7475801.

Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Fatih Türker ^*
0000-0002-8281-0319
Türkiye

Süleyman Ahbab
0000-0001-9239-9132
Türkiye

Betül Çavuşoğlu Türker
0000-0002-8041-1904
Türkiye

Esra Ataoğlu
0000-0002-6559-2575
Türkiye

Savaş Öztürk
0000-0002-6259-6132
Türkiye

Publication Date

December 31, 2021

Submission Date

November 2, 2021

Acceptance Date

December 24, 2021

Published in Issue

Year 1970 Volume: 43 Number: 4

DOI

https://doi.org/10.7197/cmj.1017675

IZ

https://izlik.org/JA48ZZ37PT

Cite

RIS / Bibtex

AMA

1.Türker F, Ahbab S, Çavuşoğlu Türker B, Ataoğlu E, Öztürk S. Clinical characteristics and outcomes of hospitalized COVID-19 patients with diabetes: A multi-center, retrospective study in Turkey. CMJ. 2021;43(4):384-395. doi:10.7197/cmj.1017675