Endocrine Abstracts

Background: The presence of diabetes and the degree of hyperglycemia is considered an independent factor in the clinical severity of COVID-19 infection, impacting the duration of hospital stay and other related medical conditions.

Objective: To identify the correlation between the insulin needs in COVID-19 patients and hospital stay and other related medical conditions. To identify the factors that would contribute to diabetes onset during COVID-19 infection.

Methods: This is a retrospective cohort study analyzing data from 70 COVID patients hospitalised between December 2020-March 2021. The cohort was stratified in 3 groups: A-patients already diagnosed with diabetes, B-patients with newly-onset diabetes, C-patients with no diabetes. Baseline characteristics, comorbidities inflammatory markers, glycemic values and clinical prognosis, including hospital stay were examined.

Results: Mean HbA1c value was 6.9% (SD±2.16), with a maximum insulin requirement of 55 UI/day (SD±42.87). Higher maximum insulin requirements were statistically related to longer hospital stay (p 0.031). All patients took dexamethasone, ranging from 4 to 40 mg (mean 13 mg) but no statistical significance was found between dexamethasone dose and maximum insulin needs. In the group with newly-onset diabetes, we noticed a statistically significant correlation between maximum total daily dose of insulin per patient during hospitalisation and hospital stay (r 0.474, p 0.035). These patients had higher HbA1c in admission (mean 5.7 % +/- 0.4 vs 5.4% +/- 0.3, P 0.026) and more comorbidities (80% vs 40%, P 0.024), mostly cardiovascular disease including hypertension (70 % vs 21%, P 0.024), compared to the group that didn’t develop diabetes.

Conclusions: Presence of diabetes affects longer hospital stay in COVID-19 patients. Prediabetes, presence of comorbidities particularly cardiovascular disease are factors that could predispose to the onset of diabetes during COVID infection.