tetano
Editor, Senior Moderator
Obes Med
. 2020 Dec 30;100316.
doi: 10.1016/j.obmed.2020.100316. Online ahead of print.
Type 2 diabetes is associated with increased risk of critical respiratory illness in patients COVID-19 in a community hospital
Ekta Shrestha[SUP] 1 [/SUP], Mariam Charkhviani[SUP] 1 [/SUP], Clio Musurakis[SUP] 1 [/SUP], Aswin Ratna Kansakar[SUP] 1 [/SUP], Amrit Devkota[SUP] 1 [/SUP], Rabin Banjade[SUP] 1 [/SUP], Prasun Pudasainee[SUP] 2 [/SUP], Solab Chitrakar[SUP] 1 [/SUP], Alisha Sharma[SUP] 1 [/SUP], Mina Sous[SUP] 1 [/SUP], Shanmugha Padhamanbhan[SUP] 1 [/SUP], Harvey J Friedman[SUP] 2 3 4 [/SUP], Guillermo Rodriguez Nava[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Type 2 diabetes (T2D) is the leading non-communicable disease worldwide and is associated with several microvascular and macrovascular complications. Individuals with T2D are more prone to acquiring selected types of infections and are more susceptible to complications due to these infections. This study aimed to evaluate the relationship between T2D and COVID-19 in the community setting.
Methods: This was a single-center retrospective analysis that included 147 adult patients with laboratory-confirmed COVID-19 admitted to a community hospital. Demographics, medical history, symptoms and signs, laboratory findings, complications during the hospital course, and treatments were collected and analyzed. The Kaplan-Meier method was used to describe the probability of intubation in patients with T2D as compared with patients without T2D. The hazard ratio for intubation in the survival analysis was estimated using a bivariable Cox proportional-hazards model.
Results: Of 147 patients, 73 (49.7%) had a history of T2D. Patients with T2D had higher requirement of ICU admission (31.5% vs 12.2%; p=.004), higher incidence of ARDS (35.6% vs 16.2%, p=.007), higher rates of intubation (32.9% vs 12.2%, p=0.003), and higher use neuromuscular blocking agents (23.3% vs 9.5%, p=.02). In the survival analysis at 28 days of follow-up, patients with T2D showed an increased hazard for intubation (HR 3.00; 95% CI, 1.39 to 6.46).
Conclusion: In our patient population, patients with COVID-19 and T2D showed significantly higher ARDS incidence and intubation rates. The survival analysis also showed that after 28 days of follow-up, patients with T2D presented an increased risk for shorter time to intubation.
Keywords: ACE2, angiotensin-converting enzyme 2; AKI, Acute kidney injury; ARDS, Acute respiratory distress syndrome; CAD, Coronary artery disease; CHF, Congestive heart failure; CK, Creatinine kinase; CKD, Chronic kidney disease; COPD, Chronic obstructive pulmonary disease; COVID-19; COVID-19, Coronavirus disease 2019; CRP, C-reactive protein; DLCO, Diffusion capacity for carbon monoxide; ESR, Erythrocyte sedimentation rate; GI, gastrointestinal; HbA1c, Glycated hemoglobin; ICU, Intensive Care Unit; IL-6, Interleukin-6; IQR, Interquartile range; PCT, Procalcitonin; Respiratory failure; SARS-CoV-2; SARS-CoV-2, Severe acute respiratory syndrome virus 2; Type 2 Diabetes; VTE, Venous thromboembolism; WHO, World Health Organization.
. 2020 Dec 30;100316.
doi: 10.1016/j.obmed.2020.100316. Online ahead of print.
Type 2 diabetes is associated with increased risk of critical respiratory illness in patients COVID-19 in a community hospital
Ekta Shrestha[SUP] 1 [/SUP], Mariam Charkhviani[SUP] 1 [/SUP], Clio Musurakis[SUP] 1 [/SUP], Aswin Ratna Kansakar[SUP] 1 [/SUP], Amrit Devkota[SUP] 1 [/SUP], Rabin Banjade[SUP] 1 [/SUP], Prasun Pudasainee[SUP] 2 [/SUP], Solab Chitrakar[SUP] 1 [/SUP], Alisha Sharma[SUP] 1 [/SUP], Mina Sous[SUP] 1 [/SUP], Shanmugha Padhamanbhan[SUP] 1 [/SUP], Harvey J Friedman[SUP] 2 3 4 [/SUP], Guillermo Rodriguez Nava[SUP] 1 [/SUP]
Affiliations
- PMID: 33392411
- PMCID: PMC7772088
- DOI: 10.1016/j.obmed.2020.100316
Abstract
Background: Type 2 diabetes (T2D) is the leading non-communicable disease worldwide and is associated with several microvascular and macrovascular complications. Individuals with T2D are more prone to acquiring selected types of infections and are more susceptible to complications due to these infections. This study aimed to evaluate the relationship between T2D and COVID-19 in the community setting.
Methods: This was a single-center retrospective analysis that included 147 adult patients with laboratory-confirmed COVID-19 admitted to a community hospital. Demographics, medical history, symptoms and signs, laboratory findings, complications during the hospital course, and treatments were collected and analyzed. The Kaplan-Meier method was used to describe the probability of intubation in patients with T2D as compared with patients without T2D. The hazard ratio for intubation in the survival analysis was estimated using a bivariable Cox proportional-hazards model.
Results: Of 147 patients, 73 (49.7%) had a history of T2D. Patients with T2D had higher requirement of ICU admission (31.5% vs 12.2%; p=.004), higher incidence of ARDS (35.6% vs 16.2%, p=.007), higher rates of intubation (32.9% vs 12.2%, p=0.003), and higher use neuromuscular blocking agents (23.3% vs 9.5%, p=.02). In the survival analysis at 28 days of follow-up, patients with T2D showed an increased hazard for intubation (HR 3.00; 95% CI, 1.39 to 6.46).
Conclusion: In our patient population, patients with COVID-19 and T2D showed significantly higher ARDS incidence and intubation rates. The survival analysis also showed that after 28 days of follow-up, patients with T2D presented an increased risk for shorter time to intubation.
Keywords: ACE2, angiotensin-converting enzyme 2; AKI, Acute kidney injury; ARDS, Acute respiratory distress syndrome; CAD, Coronary artery disease; CHF, Congestive heart failure; CK, Creatinine kinase; CKD, Chronic kidney disease; COPD, Chronic obstructive pulmonary disease; COVID-19; COVID-19, Coronavirus disease 2019; CRP, C-reactive protein; DLCO, Diffusion capacity for carbon monoxide; ESR, Erythrocyte sedimentation rate; GI, gastrointestinal; HbA1c, Glycated hemoglobin; ICU, Intensive Care Unit; IL-6, Interleukin-6; IQR, Interquartile range; PCT, Procalcitonin; Respiratory failure; SARS-CoV-2; SARS-CoV-2, Severe acute respiratory syndrome virus 2; Type 2 Diabetes; VTE, Venous thromboembolism; WHO, World Health Organization.