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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.

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Background: In-hospital cardiac arrest and death are often heralded by abnormal vital signs hours before the event. The Modified Early Warning Score (MEWS) is a physiological scoring system that assigns risk for clinical deterioration based on vital signs and clinical observation. Here we discuss our experience and effectiveness of implementation of MEWS as an important tool for triggering Rapid Response (RRT) and impact of it on patient outcome. Methods:We did a retrospective chart review of patients who had RRT called since implementation of our electronic medical record from November 2011 through June 2017 in community-based teaching hospital. The MEWS system at the time of RRT call was implemented in our hospital in 2015 and we compared the outcomes of RRT in Pre-and Post-MEWS era.Results: A total of 56,532 patients were admitted to the hospital between November 2011 and June 2017, out which 898 patients had RRTs called. There was a significant increase in RRT called from the Pre-to the Post MEWS Era (1.31% vs 1.97%, p = 0.03). The MEWS score in the Pre-MEWS era was significantly higher than in the Post-MEWS Era (4.39 vs 3.95 p = 0.0004). After the implementation of MEWS, the percentage of code blue was also decreasing. Conclusion:Implementation of MEWS in our institute has led to an increased number of RRT called and MEWS number at the time of RRT itself has decreased. Hence the utilization of MEWS has proven to be a useful tool in early recognition of deteriorating patients in our institution.