Mortality Rate and Related Risk Factors in Hospitalized Coronavirus Disease 2019 Patients with Diabetes: A Single-Center Study
Abstract
Background: The outbreak of the new coronavirus disease 2019 (COVID-19) is majorly threatening the health of people worldwide. Since patients with chronic diseases, including diabetes mellitus (DM), are among the main groups at risk of severe COVID-19; hence, this study was aimed to investigate the mortality rate of COVID-19 among patients with DM. Materials and Methods: This cross-sectional study was performed on 211 DM patients with COVID-19 who were referred to Educational Kowsar Hospital in Semnan, Iran. After a definitive diagnosis of COVID-19, basic characteristics, including gender, weight, height, and clinical information (such as initial signs and symptoms, underlying diseases, complications during hospitalization, and type of treatment received) were collected. Results: The mean age of patients was 64.92±12.7 years, and 51.7% were male. Totally 20.9% of patients were expired. The most frequent underlying diseases were hypertension and ischemic heart disease. The simultaneous presence of cardiovascular diseases in DM patients with COVID-19 was correlated with a considerable mortality rate increment. Cough on arrival significantly predicted mortality reduction to less than one-third (P=0.009). Also, oxygen saturation of less than 90% on arrival was a significant predictor of an increase in mortality by more than double (P<0.001). Conclusion: According to the results of multivariate logistic regression, it was found that DM can increment the probability of contracting COVID-19, and the rate of mortality was also higher in these patients.References
Zhang JJ, Dong X, Cao YY, Yuan YD, Yang YB, Yan YQ, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020;75:1730-41.
https://doi.org/10.1111/all.14238
PMid:32077115
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.
https://doi.org/10.1016/S0140-6736(20)30183-5
PMid:31986264
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054-62.
https://doi.org/10.1016/S0140-6736(20)30566-3
PMid:32171076
Shah BR, Hux JE. Quantifying the risk of infectious diseases for people with diabetes. Diabetes Care. 2003;26:510-3.
https://doi.org/10.2337/diacare.26.2.510
PMid:12547890
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382:1708-20.
https://doi.org/10.1056/NEJMoa2002032
PMid:32109013 PMCid:PMC7092819
Hernández-Galdamez DR, González-Block M, Romo-Dueñas DK, Lima-Morales R, Hernández-Vicente IA, Lumbreras-Guzmán M, et al. Increased Risk of Hospitalization and Death in Patients with COVID-19 and Pre-existing Noncommunicable Diseases and Modifiable Risk Factors in Mexico. Arch Med Res. 2020;51:683-9.
https://doi.org/10.1016/j.arcmed.2020.07.003
PMid:32747155 PMCid:PMC7375298
Mirzaei M, Rahmaninan M, Mirzaei M, Nadjarzadeh A. Epidemiology of diabetes mellitus, pre-diabetes, undiagnosed and uncontrolled diabetes in Central Iran: results from Yazd health study. BMC Public Health. 2020;20(1):166.
https://doi.org/10.1186/s12889-020-8267-y
PMid:32013917 PMCid:PMC6998152
Al-Ozairi E, Brown R, Hamdan Y, Alabdullah L, Voase N, Al Kandari J, et al. Risk of mortality among inpatients with COVID-19 and type 2 diabetes: National data from Kuwait. Endocrinol Diabetes Metab. 2021;4:e00287.
https://doi.org/10.1002/edm2.287
PMid:34505420 PMCid:PMC8420596
Alshukry A, Bu Abbas M, Ali Y, Alahmad B, Al-Shammari AA, Alhamar G, et al. Clinical characteristics and outcomes of COVID-19 patients with diabetes mellitus in Kuwait. Heliyon. 2021;7:e06706.
https://doi.org/10.1016/j.heliyon.2021.e06706
PMid:33842709 PMCid:PMC8020058
Zheng X, Qi Y, Bi L, Shi W, Zhang Y, Zhao D, et al. Effects of Exercise on Blood Glucose and Glycemic Variability in Type 2 Diabetic Patients with Dawn Phenomenon. Biomed Res Int. 2020;2020:6408724.
https://doi.org/10.1155/2020/6408724
PMid:32149118 PMCid:PMC7057022
Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020;323:2052-9.
https://doi.org/10.1001/jama.2020.6775
PMid:32320003 PMCid:PMC7177629
Al-Salameh A, Lanoix JP, Bennis Y, Andrejak C, Brochot E, Deschasse G, et al. Characteristics and outcomes of COVID-19 in hospitalized patients with and without diabetes. Diabetes Metab Res Rev. 2021;37:e3388.
https://doi.org/10.1002/dmrr.3388
PMid:32683744 PMCid:PMC7404605
Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Lancet Respir Med. 2020;8:e21.
https://doi.org/10.1016/S2213-2600(20)30116-8
PMid:32171062
Rogers LC, Lavery LA, Joseph WS, Armstrong DG. All Feet On Deck-The Role of Podiatry During the COVID-19 Pandemic: Preventing hospitalizations in an overburdened healthcare system, reducing amputation and death in people with diabetes. J Am Podiatr Med Assoc (in press). 2020.
https://doi.org/10.7547/20-051
PMid:32208983
Sheng CC, Sahoo D, Dugar S, Prada RA, Wang TKM, Abou Hassan OK, et al. Canakinumab to reduce deterioration of cardiac and respiratory function in SARS-CoV-2 associated myocardial injury with heightened inflammation (canakinumab in Covid-19 cardiac injury: The three C study). Clin Cardiol. 2020;43:1055-63.
https://doi.org/10.1002/clc.23451
PMid:32830894 PMCid:PMC7461303
Khalili S, Sabaghian T, Sedaghat M, Soroureddin Z, Askari E, Khalili N. Prevalence, Risk Factors and Outcomes Associated with Acute Kidney Injury in Patients Hospitalized for COVID-19: A Comparative Study between Diabetic and Nondiabetic Patients. J Diabetes Res. 2021;2021:6666086.
https://doi.org/10.1155/2021/6666086
PMid:33506050 PMCid:PMC7808817
Guo W, Li M, Dong Y, Zhou H, Zhang Z, Tian C, et al. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metab Res Rev. 2020;36:e3319.
https://doi.org/10.1002/dmrr.3319
PMCid:PMC7228407
Muniyappa R, Gubbi S. COVID-19 pandemic, coronaviruses, and diabetes mellitus. Am J Physiol Endocrinol Metab. 2020;318(5):E736-41.
https://doi.org/10.1152/ajpendo.00124.2020
PMid:32228322 PMCid:PMC7191633
Roncon L, Zuin M, Rigatelli G, Zuliani G. Diabetic patients with COVID-19 infection are at higher risk of ICU admission and poor short-term outcome. J Clin Virol. 2020;127:104354.
https://doi.org/10.1016/j.jcv.2020.104354
PMid:32305882 PMCid:PMC7195018
Hopkins C, Surda P, Kumar N. Presentation of new onset anosmia during the COVID-19 pandemic. Rhinology. 2020;58:295-8.
https://doi.org/10.4193/Rhin20.116
PMid:32277751
Vardavas CI, Nikitara K. COVID-19 and smoking: A systematic review of the evidence. Tob Induc Dis. 2020;18:20.
https://doi.org/10.18332/tid/119324
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