Diabetes has been shown to be a risk factor for corona virus disease-2019 (COVID-19) infection. The characteristics of patients with diabetes vulnerable to this infection are less specified. We aim to present the characteristics of patients with diabetes admitted to hospital with COVID-19. Design: A retrospective case series. Setting: A single clinical centre in the UK. Methods: We have retrospectively collected the demographics, medical characteristics and outcome of all patients with diabetes admitted to hospital over two-week period with COVID-19 infection. All cases were diagnosed by a reverse transcription polymerase chain reaction (RT-PCR) of pharyngeal and nasal swabs. Results: A total of 71 COVID-19 patients were admitted during the study period of whom 16 (22.5%) patients had diabetes and were included in this case series. There was no significant difference between patients with compared to those without diabetes regarding age, gender or clinical presentation. However, comorbidities were more common in patients with diabetes specially hypertension {75% v 36.4%, a difference of 38.6%, 95% confidence interval (CI) 6.5-58.3} and chronic kidney disease (37.5 v 5.5, a difference of 32% (1.6-51.6). Patients with diabetes were significantly more obese than those without diabetes (56.2% v 21.8% a difference of 34.4%, 95% CI 7.7-61.1). About one third (31.3%) of patients with diabetes were frail. Mean {standard deviation (SD)} duration of diabetes was 10 (2.8) years and mean (SD) HbA1c was 60.3 (15.6) mmol/mol. The use of angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs) and non-steroidal
Objectives In December 2019, a pneumonia‐like illness was first reported in Wuhan‐China caused by a new coronavirus named corona virus disease‐2019 (COVID‐19) which then spread to cause a global pandemic. Most of the available data in the literature is derived from Chinese cohorts and we aim to contribute the clinical experience of a single British clinical centre with the characteristics of a British cohort. Design A prospective case series. Setting: A single clinical centre in the UK. Methods: We have collected the demographics and medical characteristics of all COVID‐19–positive cases admitted over 2‐week period. All cases were diagnosed by PCR. Results Total of 71 COVID‐19 patients were included in this case series. Majority of patients (75%) were ≥75 years old and 58% were men. Pre‐existing comorbidities was common (85% of patients). Most patients presented with respiratory symptoms such as fever (59%), shortness of breath (56%) and cough (55%). Gastrointestinal symptoms were second‐most common presenting compliant such as diarrhoea (10%) and abdominal pain (7%). Opacification in chest X‐rays was demonstrated in 45% of patients. All patients received supportive treatment and no specific antiviral therapy was administered in this cohort. So far, 18 (25%) patients have fully recovered, 9 patients (13%) escalated to a higher level of care and 10 (14%) have died. Patients who died were non‐significantly older than those who have recovered (78.0 vs 69.2 years, P = .15) but they had a significantly higher clinical frailty scores (5.75 vs 3.36, P = .005). Conclusion This case series demonstrated that the characteristics of British COVID‐19 patients were generally similar to what is published in literature, although we report more gastrointestinal symptoms at presentation. We have identified frailty as a risk factor for adverse outcome in COVID‐19 patients and suggest that it should be included in the future vaccination recommendations.
The COVID-19 pandemic initially started in China then spread to Europe. It is not known whether COVID-19 affects patients differently across the two continents. We aimed to describe our cohort of patients admitted to a single British centre with COVID-19 in comparison to a Chinese cohort of similar size and admitted over a similar time period to Chinese centres. We present a comparison of 62 Chinese and 71 British cases hospitalised for COVID-19. Cases in both sites were confirmed by a positive RT-PCR of nasopharyngeal swabs. Comparison analysis highlighted some differences between both populations. The most striking difference is the significantly older age of the British population (72% of the British ≥ 66 years compared to only 3% of the Chinese patients, difference of 69%, 95% confidence interval (CI) 68.3% to 69.7%, respectively) and the associated significant premorbid conditions (85% of patients vs 32%, difference of 53%, 95% CI 52 to 54%, respectively). Gastrointestinal and general symptoms were more common clinical presentation in the British while respiratory symptoms were more prominent in the Chinese cohort. Mortality was significantly higher in the British cohort 14% compared to none in the Chinese cohort (difference of 14%, 95% CI 13.7 to 14.3%). We conclude that COVID-19 does present differently in these two cohorts, but the apparent differences in the clinical presentations could be explained by the inherent differences in the demographics and case mix between both countries.
Objectives: In December 2019, a pneumonia like illness was first reported in Wuhan-China caused by a new coronavirus named corona virus disease-2019 (COVID-19) which then spread to cause a global pandemic. Most of the available data in the literature is derived from Chinese cohorts and we aim to contribute the clinical experience of a single British clinical centre with the characteristics of a British cohort. Design: A prospective case series. Setting: A single clinical centre in the UK. Methods: We have collected the demographics and medical characteristics of all COVID-19 positive cases admitted over two-week period. All cases were diagnosed by PCR. Results: Total of 71 COVID-19 patients were included in this case series. Majority of patients (75%) were [?]75 years old and 58% were men. Pre-existing comorbidities was common (85% of patients). Most patients presented with respiratory symptoms such as fever (59%), shortness of breath (56%) and cough (55%). Gastrointestinal symptoms were second most common presenting compliant such as diarrhoea (10%) and abdominal pain (7%). Opacification in chest X-rays were demonstrated in 45% of patients. All patients received supportive treatment and no specific antiviral therapy was administered in this cohort. So far, 18 (25%) patients have fully recovered, 9 patients (13%) escalated to a higher level of care and 10 (14%) have died. Patients who died were non-significantly older than those who have recovered (78.0 v 69.2 years, p=0.15) but they had a significantly higher clinical frailty scores (5.75 v 3.36, p=0.005). Conclusion: This case series demonstrated that the characteristics of British COVID-19 patients were generally similar to what is published in literature although we report more gastrointestinal symptoms at presentation. We have identified frailty as a risk factor for adverse outcome in COVID-19 patients and suggest that it should be included in the future vaccination recommendations.
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