DIABETES MELLITUS IN COVID-19; A HOSPITAL-BASED LONGITUDINAL ANALYTICAL STUDY
DOI:
https://doi.org/10.22159/ajpcr.2022.v15i6.44680Keywords:
Co-morbidities,, Outcome, LDH, CRPAbstract
Objectives: The aim of the study was (1) to assess and compare the profile of COVID-19 patients with diabetes and without diabetes and (2) to determine the outcome of COVID-19 patients with diabetes mellitus.
Methods: A hospital-based longitudinal analytical study was conducted on a total of 2000 patients in Bengaluru during the study period from August 2020 to July 2021. The patients fulfilling the inclusion criteria were enrolled for the study after obtaining informed consent. Patients were divided into diabetic and non-diabetic groups and inflammatory markers were compared between these two groups and outcome of these patients was noted.
Results: Of the 2000 COVID-19 patients included, 358 were diabetics in this study. Mean age of non-diabetic patients was 41.71 (±15.37) years and diabetic patients were 54.37 (±11.95) years. The inflammatory markers such as Lactate Dehydrogenase (LDH), Ferritin, C-Reactive Protein (CRP), and Neutrophil-Lymphocyte ratio (NLR) were significantly high in patients with diabetes compared to the non-diabetic patients with COVID-19 (p<0.05).
Conclusion: This study shows that diabetes is a major risk factor and contributes to the severity and mortality of patients with COVID-19. Our recommendations are for the strict glycemic control in patients affected by COVID-19 during treatment for the same.
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References
World Health Organization. Coronavirus disease (COVID-19). Geneva: World Health Organization; 2021.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. Lancet 2020;395:507- 13. doi: 10.1016/S0140-6736(20)30211-7, PMID 32007143
Walls AC, Park YJ, Tortorici MA, Wall A, Veesler D, McGuire AT, et al. Structure, function and antigenicity of the SARS-CoV-2 spike glycoprotein. Cel. 2020;181:281-92.
Zhang H, Penninger JM, Li Y, Zhong N, Slutsky AS. Angiotensin-converting enzyme 2 (ACE2) as a SARS-CoV-2 receptor: Molecular mechanisms and potential therapeutic target. Intensive Care Med 2020;46:586-90. doi: 10.1007/s00134-020-05985-9, PMID 32125455
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506. doi: 10.1016/S0140-6736(20)30183-5, PMID 31986264
Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72 314 Cases from the Chinese center for disease control and prevention. JAMA 2020;323:1239-42. doi: 10.1001/jama.2020.2648, PMID 32091533
Holman N, Knighton P, Kar P, O’Keefe J, Curley M, Weaver A, et al. Risk factors for COVID-19-related mortality in people with Type 1 and Type 2 diabetes in England: A population-based cohort study. Lancet Diabetes Endocrinol 2020;8:823-33. doi: 10.1016/S2213- 8587(20)30271-0, PMID 32798471
Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy region, Italy. JAMA 2020;323:1574-81. doi: 10.1001/jama.2020.5394, PMID 32250385
Goyal P, Choi JJ, Pinheiro LC, Schenck EJ, Chen R, Jabri A, et al. Clinical characteristics of Covid-19 in New York city. N Engl J Med 2020;382:2372-4. doi: 10.1056/NEJMc2010419, PMID 32302078
Piva S, Filippini M, Turla F, Cattaneo S, Margola A, De Fulviis S, et al. Clinical presentation and initial management critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Brescia, Italy. J Crit Care 2020;58:29-33. doi: 10.1016/j. jcrc.2020.04.004, PMID 32330817
Myers LC, Parodi SM, Escobar GJ, Liu VX. Characteristics of hospitalized adults with COVID-19 in an integrated health care system in California. JAMA 2020;323:2195-8. doi: 10.1001/jama.2020.7202, PMID 32329797
Wu F, Zhao S, Yu B, Chen YM, Wang W, Song ZG, et al. A new coronavirus associated with human respiratory disease in China. Nature 2020;579:265-9. doi: 10.1038/s41586-020-2008-3, PMID 32015508
Batlle D, Soler MJ, Ye M. ACE2 and diabetes: ACE of ACEs? Diabetes 2010;59:2994-6. doi: 10.2337/db10-1205, PMID 21115782
Bindom SM, Lazartigues E. The sweeter side of ACE2: Physiological evidence for a role in diabetes. Mol Cell Endocrinol 2009;302:193-202. doi: 10.1016/j.mce.2008.09.020, PMID 18948167
Xuan X, Gao F, Ma X, Huang C, Wang Y, Deng H, et al. Activation of ACE2/angiotensin (1-7) attenuates pancreatic β cell dedifferentiation in a high-fat-diet mouse model. Metabolism 2018;81:83-96. doi: 10.1016/j.metabol.2017.12.003, PMID 29225087
Varikasuvu SR, Varshney S, Dutt N. Markers of coagulation dysfunction and inflammation in diabetic and non-diabetic COVID-19. J Thromb Thrombolysis 2020;51:941-6.
Abdi A, Jalilian M, Sarbarzeh PA, Vlaisavljevic Z. Diabetes and COVID-19: A systematic review on the current evidences. Diabetes Res Clin Pract 2020;166:108347.
Apicella M, Campopiano MC, Mantuano M, Mazoni L, Coppelli A, Del Prato S. COVID-19 in people with diabetes: Understanding the reasons for worse outcomes. Lancet Diabetes Endocrinol 2020;8:782-92. doi: 10.1016/S2213-8587(20)30238-2, PMID 32687793
International Diabetes Federation. COVID-19 outbreak: Guidance for people with diabetes. Belgium: International Diabetes Federation; 2020.
Wang G, Wu C, Zhang Q, Wu F, Yu B, Lv J, et al. Epidemiological and Clinical Features of Corona Virus Disease 2019 (COVID-19) in Changsha; 2020.
Wan S, Xiang Y, Fang W, Zheng Y, Li B, Hu Y, et al. Clinical features and treatment of COVID-19 patients in Northeast chongqing. J Med Virol 2020;92:797-806. doi: 10.1002/jmv.25783, PMID 32198776
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Copyright (c) 2022 Dr Avinash Rajanna, Dr Ravi K, Dr Abhiman Shetty, Dr Vaibhav S B, Dr Bhargav Bhat, Dr Yamini Marimuthu
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