Endocrine Abstracts

Introduction: Although the effect of pre-admission insulin usage (PAIU) in diabetic COVID-19 patients remains uncertain, early studies have reported worse results in this group. Studies generally report in-hospital mortality rates. However, mortality also increases after discharge in COVID-19 patients; the effect of PAIU on this issue is unknown. This study was conducted to examine the effect of PAIU on COVID-19 diabetics’ 90-day mortality data, including the post-discharge period.

Material Method: All diabetic patients hospitalized in Canakkale Onsekiz Mart University Medical Faculty Hospital between March 2020 and December 2020 due to COVID-19 were retrospectively included in the study. 90-day mortality and PAIU data were obtained from health system records. Cox regression was used to estimate the hazard ratio (HR) of COVID-19-related mortality in people PAIU, with covariate adjustment confounding by clinical and laboratory factors.

Results: In 631 diabetic patients, the PAIU rate was 33.4%. The 90-day mortality rate in PAIU was higher than non-insulin user diabetics (33.2% vs. 24.3%, P: 0.018). Univariate logistic regression analysis was showed that 90-day mortality increased 1.54 times in PAIU patients (OR=1.54, 95% CI=1.07-2.22, P=0.018). Nevertheless, the mortality effect of PAUI disappears when adjusted according to age, gender, presence of COPD, presence of hypertension, creatinine, ALT and glucose levels. The adjusted HR of PAIU was 1.26 (95% CI 0.91–1.74, P=0.15). In this model, the effects of glucose level, age, and creatinine levels on mortality were significant.

Conclusion: In our study, mortality was higher in insulin users. However, when confounding factors were adjusted, the insulin’s effect on the mortality rate was disappeared. PAIU is neutral for COVID-19 mortality.