IMPACT OF DIABETES MELLITUS ON CLINICAL PROFILE AND OUTCOME OF COVID-19 PATIENTS IN A TERTIARY CARE HOSPITAL
Keywords:COVID-19, Diabetes, Clinical profile, Treatment outcome
Objective: A novel coronavirus infection (SARS-CoV-2) pneumonia (COVID-19) has been quickly spreading throughout China and the rest of the world since December 2019. Respiratory tract infections are frequently linked to diabetes mellitus (DM), a different risk factor. This study has reported the clinical presentation and therapeutic outcomes of COVID-19 with diabetes.
Methods: From medical records and histories provided by 72 Covid-19-infected patients with diabetes admitted to the KMCH institute of health sciences and research, Coimbatore, data on demographics, clinical, laboratory, and radiological characteristics as well as treatment outcomes were collected using data collection forms. Real-time reverse transcription polymerase chain reaction (RT-PCR) assay of 2019-CoV RNA was used to screen patients with Covid-19.
Results: 72 diabetes patients who tested positive for Covid-19 were admitted for this study. SPSS software version 26 was used to evaluate the data that had been collected. Clinical profiles and outcomes of patients with and without diabetes underwent descriptive analysis. Controlled diabetics had a mean plasma glucose of 112.22±11.41, while uncontrolled diabetics had a mean plasma glucose of 154.2±23.22. Fever was the most prevalent symptom in both managed and uncontrolled diabetes patients (94% and 100%), followed by sore throat (84% and 88%). In patients with uncontrolled diabetes compared to those with controlled diabetes, breathlessness is considerably higher (p<0.05). In the CORADS scoring, 11 of the 34 diabetics with uncontrolled blood sugar levels had CORADS 6 (32.35%), compared to just 2 of the 38 diabetics with regulated blood sugar levels (5.26%), which is considerably higher (p<0.01). In uncontrolled diabetics, the length of hospital stay is much longer (p<0.001). Compared to diabetics with controlled blood sugar, uncontrolled patients SPO2 dramatically dropped (p<0.001). Those with uncontrolled diabetes are more likely to be admitted to the ICU than patients with controlled diabetes (p<0.05). In uncontrolled diabetes compared to controlled patients, the severity was considerably higher (p<0.05). One person who had uncontrolled diabetes died, although no one who had controlled diabetes died.
Conclusion: Covid 19, persons with uncontrolled diabetes appear to be more likely to sustain lung damage, necessitating admission to the ICU, an extended stay in the hospital, and oxygen assistance throughout the duration of the illness.
Tu H, Tu S, Gao S, Shao A, Sheng J. Current epidemiological and clinical features of COVID-19; a global perspective from China. The COVID-19 reader. 2020;30:53-72.
Niharika D, Niharika B, Aishwarya T, Nikitha A, Butool R, Ibrahim M. Coronavirus-A virus in learning. Int J Curr Pharm Sci. 2020;12(4):7-10. doi: 10.22159/ijcpr.2020v12i4.39078.
Sukumaran S, Sathianarayanan S. A review on Covid-19 pandemic a global threat-current status and challenges and preventive strategies. Int J App Pharm. 2021;13(5):10-4. doi: 10.22159/ijap.2021v13i5.42070.
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020 Jan 24;382(8):727-33. doi: 10.1056/NEJMoa2001017, PMID 31978945.
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 Jul;75(7):1730-41. doi: 10.1111/all.14238, PMID 32077115.
Rajgor DD, Lee MH, Archuleta S, Bagdasarian N, Quek SC. The many estimates of the COVID-19 case fatality rate. Lancet Infect Dis. 2020 Jul 1;20(7):776-7. doi: 10.1016/S1473-3099(20)30244-9, PMID 32224313.
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.
Bhandari S, Bhargava A, Sharma S, Keshwani P, Sharma R, Banerjee S. Clinical profile of covid-19 infected patients admitted in a tertiary care hospital in North India. J Assoc Physicians India. 2020;68(5):13-7. PMID 32610859.
Gupta N, Sumita Agrawal, Pranav Ish, Suruchi Mishra. Clinical and epidemiologic profile of the initial COVID-19 patients at a tertiary care centre in India. Monaldi Arch Chest Dis. 2020;10:90.
Vishnu Pal, VK Sharma, Alok Kulsherstha. An epidemiological study of covid-19 cases admitted in a dedicated covid hospital during the second wave of corona pandemic in central India. Asian J Pharm Clin Res. 2022;15(12).
Kulkarni MK, Patel P, Yadav N, Gupta S. Clinical profile and outcome of covid-19 patients: a retrospective observational study from tertiary care center in North India. SK T, Ravishekar NH, SK C. Asian J Pharm Clin Res. 2022;15(5):128-31.
Barron E, Bakhai C, Kar P, Weaver A, Bradley D, Ismail H. Associations of type 1 and type 2 diabetes with COVID-19-related mortality in England: a whole-population study. Lancet Diabetes Endocrinol. 2020;8(10):813-22. doi: 10.1016/S2213-8587(20)30272-2. PMID 32798472.
Cariou B, Hadjadj S, Wargny M, Pichelin M, Al-Salameh A, Allix I. Phenotypic characteristics and prognosis of inpatients with COVID-19 and diabetes: the CORONADO study. Diabetologia. 2020 Aug;63(8):1500-15. doi: 10.1007/s00125-020-05180-x, PMID 32472191.
Yang JK, Lin SS, Ji XJ, Guo LM. Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes. Acta Diabetol. 2010 Sep;47(3):193-9. doi: 10.1007/s00592-009-0109-4, PMID 19333547.
Khateeb J, Fuchs E, Khamaisi M. Diabetes and lung disease: an underestimated relationship. Rev Diabet Stud. 2019 Jul 30;15(1):1-15. doi: 10.1900/RDS.2019.15.1.
Randeria SN, Thomson GJA, Nell TA, Roberts T, Pretorius E. Inflammatory cytokines in type 2 diabetes mellitus as facilitators of hypercoagulation and abnormal clot formation. Cardiovasc Diabetol. 2019 Dec;18(1):72. doi: 10.1186/s12933-019-0870-9, PMID 31164120.
Kozakova M, Morizzo C, Goncalves I, Natali A, Nilsson J, Palombo C. Cardiovascular organ damage in type 2 diabetes mellitus: the role of lipids and inflammation. Cardiovasc Diabetol. 2019 Dec;18(1):61. doi: 10.1186/s12933-019-0865-6, PMID 31077210.
Liu B, Li M, Zhou Z, Guan X, Xiang Y. Can we use interleukin-6 (IL-6) blockade for coronavirus disease 2019 (COVID-19)-induced cytokine release syndrome (CRS)? J Autoimmun. 2020 Jul 1;111:102452. doi: 10.1016/j.jaut.2020.102452, PMID 32291137.
Luo P, Liu Y, Qiu L, Liu X, Liu D, Li J. Tocilizumab treatment in COVID‐19: a single center experience. J Med Virol. 2020 Jul;92(7):814-8. doi: 10.1002/jmv.25801, PMID 32253759.
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