The Risk of Diabetes on Clinical Outcomes in Patients with Coronavirus Disease 2019: A Retrospective Cohort Study

• Published in: Diabetes & metabolism journal Vol. 44; no. 3; pp. 405 - 413
• Main Authors: Chung, Seung Min, Lee, Yin Young, Ha, Eunyeong, Yoon, Ji Sung, Won, Kyu Chang, Lee, Hyoung Woo, Hur, Jian, Hong, Kyung Soo, Jang, Jong Geol, Jin, Hyun Jung, Choi, Eun Young, Shin, Kyeong-Cheol, Chung, Jin Hong, Lee, Kwan Ho, Ahn, June Hong, Moon, Jun Sung
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Diabetes Association / Daehan Dangnyobyeong Hakoe 01.06.2020; Korean Diabetes Association; 대한당뇨병학회
• Subjects: Adult; Age; Aged; Clinical outcomes; Cohort analysis; Coronavirus Infections - complications; Coronavirus Infections - mortality; COVID-19; Diabetes; Diabetes Complications - mortality; Diabetes Complications - virology; diabetes mellitus; Disease control; Disease transmission; Factor Analysis, Statistical; Female; Glucose; Humans; Hypertension; Infections; Kidneys; Male; Middle Aged; Mortality; Neutrophils; Original; Pandemics; Patients; Pneumonia; Pneumonia, Viral - complications; Pneumonia, Viral - mortality; prognosis; Republic of Korea - epidemiology; Retrospective Studies; risk factors; Sepsis; Severe acute respiratory syndrome coronavirus 2; 내과학; Republic of Korea; China; COVID-19; Severe acute respiratory syndrome coronavirus 2; Aged; Prognosis; Diabetes mellitus; Risk factors
• ISSN: 2233-6079; 2233-6087; 2233-6087
• DOI: 10.4093/dmj.2020.0105

To determine the role of diabetes mellitus (DM) in the coronavirus disease 2019 (COVID-19), we explored the clinical characteristics of patients with DM and compared risk factors such as age, glycemic control, and medications to those without DM. This was a retrospective cohort study of 117 confirmed patients with COVID-19 which conducted at a tertiary hospital in Daegu, South Korea. The primary outcome was defined as the severe and critical outcome (SCO), of which the composite outcomes of acute respiratory distress syndrome, septic shock, intensive care unit care, and 28-day mortality. We analyzed what clinical features and glycemic control-related factors affect the prognosis of COVID-19 in the DM group. After exclusion, 110 participants were finally included. DM patients ( =29) was older, and showed higher blood pressure compared to non-DM patients. DM group showed higher levels of inflammation-related biomarkers and severity score, and highly progressed to SCO. After adjustment with other risk factors, DM increased the risk of SCO (odds ratio [OR], 10.771; <0.001). Among the DM patients, SCO was more prevalent in elderly patients of ≥70 years old and age was an independent risk factor for SCO in patients with DM (OR, 1.175; =0.014), while glycemic control was not. The use of medication did not affect the SCO, but the renin-angiotensin system inhibitors showed protective effects against acute cardiac injury (OR, 0.048; =0.045). The COVID-19 patients with DM had higher severity and resulted in SCO. Intensive and aggressive monitoring of COVID-19 clinical outcomes in DM group, especially in elderly patients is warranted.