Endocrine Abstracts

Background: The relationship between diabetes and COVID-19 is known to be bidirectional. Diabetes Mellitus (DM) and hyperglycemia are important risk factors for poor outcomes in hospitalized patients with coronavirus disease 2019 (COVID-19) pneumonia.

Objective: This study aimed to evaluate the impact of glycemic control pre- and after admission, on outcomes of hospitalised patients with COVID-19 pneumonia.

Methods: A total of 400 hospitalized patients with confirmed COVID-19-pneumonia during the interval 2020-2021 in e tertiary Hospital Center in Albania were included in the present study. Diabetic patients were classified in two groups, new onset and pre-existing diabetes. The outcomes were compared with non-DM patients with COVID-19 pneumonia. At the same time we analysed how mean glucose during the hospitalization period could influence final outcomes regarding in-hospital case fatality and in-hospital adverse events.

Results: Overall, 400 hospitalizations with confirmed COVID-19 pneumonia were documented. COVID-19 patients with DM demonstrated an aggravated comorbidity profile, with a higher Charlson comorbidity index. Risk for acute respiratory distress syndrome (96% CI: 1.57–1.64), P<0.001), non-invasive ventilation (95% CI: 1.43–1.57), P<0.001 and mechanical ventilation (95% CI: 1.39–1.48), P<0.001 were increased in DM patients. DM was an independent risk factor for in-hospital complications like major cardiac events, acute kidney failure, and in-hospital mortality (OR: 1.24 (95% CI: 1.25–1.31), P<0.001)Severe hyperglycemia (mean blood glucose > 250 mg/dl) on second day of hospitalization was associated with high mortality compared with patients with mean blood glucose around 140 mg/dl. In-hospital hypoglycemia events (blood glucose < 70 mg/dl) was also associated with increased mortality.

Conclusion: In patients with COVID-19-pneumonia, DM is a important risk factor for adverse events and fatality. Severe hyperglycemia and hypoglycemia events after admission were both strong predictors of poor outcomes. Diabetics patients with COVID-19 are a vulnerable group that requires intense medical care and need to be strictly monitored during hospitalization.

Keywords: Diabetes mellitus, COVID-19-pneumonia, in-hospital complications, intensive care.