The clinical profile and associated mortality in people with and without diabetes with Coronavirus disease 2019 on admission to acute hospital services

Krishna Gokhale, SA Mostafa, Jingya Wang, Abd Tahrani, Chris Sainsbury, Konstantinos Toulis, G Neil Thomas, Zaki Hassan-Smith, Elizabeth Sapey, Suzy Gallier, Nicola Adderley, Parth Narendran, Srikanth Bellary, Thomas Taverner, Subrata Ghosh, Krishnarajah Nirantharakumar, Wasim Hanif

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Abstract

Introduction: To assess if in adults with COVID-19, whether those with diabetes and complications (DM+C) present with a more severe clinical profile and if that relates to increased mortality, compared to those with diabetes with no complications (DM-NC) and those without diabetes.

Methods: Service-level data was used from 996 adults with laboratory confirmed COVID-19 who presented to the Queen Elizabeth Hospital Birmingham, UK, from March to June 2020. All individuals were categorized into DM+C, DM-NC, and non-diabetes groups. Physiological and laboratory measurements in the first 5 days after admission were collated and compared among groups. Cox proportional hazards regression models were used to evaluate associations between diabetes status and the risk of mortality.

Results: Among the 996 individuals, 104 (10.4%) were DM+C, 295 (29.6%) DM-NC and 597 (59.9%) non-diabetes. There were 309 (31.0%) in-hospital deaths documented, 40 (4.0% of total cohort) were DM+C, 99 (9.9%) DM-NC and 170 (17.0%) non-diabetes. Individuals with DM+C were more likely to present with high anion gap/metabolic acidosis, features of renal impairment, and low albumin/lymphocyte count than those with DM-NC or those without diabetes. There was no significant difference in mortality rates among the groups: compared to individuals without diabetes, the adjusted HRs were 1.39 (95% CI 0.95–2.03, p = 0.093) and 1.18 (95% CI 0.90–1.54, p = 0.226) in DM+C and DM-C, respectively.

Conclusions: Those with COVID-19 and DM+C presented with a more severe clinical and biochemical profile, but this did not associate with increased mortality in this study.
Original languageEnglish
Article numbere00309
Number of pages11
JournalEndocrinology, diabetes & metabolism
Early online date3 Dec 2021
DOIs
Publication statusE-pub ahead of print - 3 Dec 2021

Bibliographical note

Funding Information:
SAM has received research support from Novo Nordisk Research Foundation UK and Academy of medical Sciences. SB has received grants, personal fees, and support to attend educational meetings from Novo Nordisk; grants from The Binding Site; personal fees from AstraZeneca, Merck, Sharpe & Dohme, and Janssen; personal fees and support to attend educational meetings from Boehringer Ingelheim; personal fees and support to attend educational meetings from Eli Lilly; and personal fees and support to attend educational meetings from Sanofi‐Aventis and NAPP. WH has received Received Research Grants, Travel Grant and Consultancy for following AZ, BI, Eli Lilly, Jansen, Novo Nordisk, Sanofi, NAPP and MSD. Other authors have no declarations.

Publisher Copyright:
© 2021 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.

Keywords

  • COVID-19
  • complications
  • diabetes

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

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