Endocrine Abstracts

Coronavirus disease 2019 (COVID 19) caused by severe acute respiratory syndrome corona virus 2 (SARS – CoV-2) which predominantly affects lungs and leads to COVID 19 pneumonia. India is second worst affected country in the world after U.S having more than 10 Million COVID 19 cases till date. Diabetes is frequently associated with severe COVID-19 infection and with a worse prognosis. This retrospective study aims to evaluate the impact of diabetes mellitus on baseline SpO2 levels on admission and Chest CT severity score in patients affected with COVID-19 infection.

Materials and methods

In this observational study 157 symptomatic COVID-19 patients were included at a dedicated COVID hospital in Rural India from July 22, 2020 to Oct 12, 2020. The COVID19 positivity was defined on the basis of RT PCR. Baseline SpO2, HRCT Chest scans, inflammatory markers such as CRP, Ferritin and D-Dimer were done at the time of admission. A semi-quantitative CT severity score was calculated based on the extent of lobar involvement (0:0%; 1: `  5%; 2: 5–25%; 3: 26–50%; 4: 51–75%; 5: b  75%; range 0–5; global score 0–25). Data were compared using Mann Whitney U test.

Results

In this study baseline SpO2 levels were 90.24 ± 4.61 (Mean ± S.D.) in patients with diabetes and 92.72 ± 4.09 (Mean ± S.D.) in patients without diabetes. Patients with diabetes had lower baseline SpO2 levels which were statistically significant (P: < 0.001). CT severity score in patients with diabetes was higher than patients without diabetes with t value of -1.833 (P: 0.069).

Conclusions

This study data suggests the potential role of simple and cost effective measurement like baseline SpO2 on room air for predicting the severity of lung involvement in SARS-CoV-2 patients with diabetes mellitus. This observational study shows COVID-19 patients with diabetes had significantly lower SpO2 levels. This study also shows that CT severity score was higher in diabetics compared to non-diabetics. COVID-19 infection with diabetes is more likely to cause more severe pneumonia with severe hypoxia. CRP and other inflammatory markers were also elevated in diabetics. This could be also due to people with diabetes have a dysregulated innate and adaptive immune response and their already having chronic low-grade inflammation which makes them more susceptible to more severe pulmonary disease. Further large scale studies are needed to validate the clinical implications of this study.