Endocrine Abstracts

Background: Studies suggest that diabetes mellitus (DM) is associated with greater risk of developing severe forms of COVID-19 and mortality.

Aims: To compare clinical characteristics and outcomes in hospitalized COVID-19 patients with and without DM.

Methods: A single-center, retrospective, observational study included adult patients with laboratory-confirmed COVID-19 treated at VUHSK between 2020-01-01 and 2021-03-31. Patients were allocated to DM and non-DM grousp. The demographic, laboratory and outcomes data were compared. Disease severity was described as requirement of either high flow oxygen, intubation or inotropic support.

Results: A total of 2559 patients (median age 60 years, 1424 (55.6%) men) were included. Compared with the non-DM group (n=2058, 80.4%), patients with DM (n=501, 19.6%) were older, had more co-morbidities: hypertension, coronary artery disease, heart failure, dyslipidaemia, obesity, chronic kidney disease (P<0.05). Serum glucose, CRP, procalcitonin, D-dimer, creatinine and lactate were significantly higher (P<0.05), eGFR and LYM count - significantly lower (P<0.05) in the DM group compared to non-DM. Patients with DM were more likely to develop acute respiratory failure (31.3 vs 20.9%; OR 1.728, 95% CI 1.391-2.146), sepsis or septic shock (9.2 vs 6.3%, OR 1.512, CI 1.063-2.149) acute kidney failure (18.4 vs 11.6%, OR 1.712, CI 1.316-2.228), to require high flow oxygen or non-invasive ventilation (16.4 vs 9.3%, P=0.000), intubation (12.2 vs 8.1%, P=0.004), inotropic support (4.6 vs 2.5%, P=0.014), stayed longer at the hospital (median 11 vs 13 days, P=0.000), had higher prevalence of severe disease (23.0 vs 14.7%, OR 1.732, CI 1.361-2.205) and mortality rate compared to non-DM patients (19.6 vs 12.7%, OR 1.674, CI 1.296-2.163). After matching for age and gender, DM remained significant risk factor for developing respiratory failure (OR 1.533, CI 1.157-2.031) and severe disease (OR 1.569, CI 1.142-2.154), but not death (19.4 vs 15.4%, OR 1.322, CI 0.952-1.837; P=0.095).

Conclusions: Diabetes was prevalent in one fifth of patients hospitalized with COVID-19. It was associated with longer hospitalization, greater risk of severe COVID-19 disease and death. Further investigation of the relationship between COVID-19 severity and diabetes is warranted.

Keywords: coronavirus disease 2019 (COVID-19); diabetes; mortality; outcome.