Survival of patients with diabetes mellitus hospitalized for acute respiratory syndrome due to COVID-19

Abstract

Given the magnitude of COVID-19 and the increase in hospitalization cases for severe acute respiratory syndrome (SARS), especially among patients with diabetes mellitus, it is essential to understand the epidemiological aspects inherent to the disease and the worsening of cases. Thus, this study aimed to analyze the survival of patients with diabetes mellitus hospitalized for SARS due to COVID-19 in different regions of Brazil. This is a longitudinal study, carried out based on data reported in the Influenza Epidemiological Surveillance Information System during the year 2020. The number of patients with diabetes mellitus among the hospitalized cases of SARS due to COVID-19 in the different regions of Brazil and the lethality rate among them were identified. A comparison of patient profiles of those who survived or did not survive and the Cox regression analysis were performed to evaluate the factors associated with shorter survival of patients. It was found that 51.4% of patients hospitalized with SARS due to COVID-19 had diabetes, and the case lethality rate among them was 45.0%. The Northeastern and Northern regions presented a higher proportion of patients with diabetes mellitus (56.5% and 54.3%, respectively) and a higher lethality rate (53.8% and 59.9%, respectively). The mean survival time of cases with diabetes mellitus hospitalized for SARS due to COVID-19 was estimated to be 35.7 days (0.5 days). A lower survival rate was observed among residents of the Northeastern and Northern regions with skin color reported as non-white, who required admission to Intensive Care Units and invasive mechanical ventilation, and presented respiratory symptoms such as dyspnea, respiratory distress and an oxygen saturation lower than 95%. It is concluded that diabetes mellitus was responsible for the high occurrence and lethality, mainly in the Northeastern and Northern regions, among non-white patients and those with greater clinical severity, which reinforces the importance of taking measures aimed at supporting this population.

Diabetes is associated with increased risk of death in COVID‐19 hospitalizations in Mexico 2020: A retrospective cohort study

“…A 2021 survival analysis in Uganda found a 22.5% mortality in COVID‐19 patients hospitalized and 40% higher hazard ratios (HR: 1.4, CI: 1–2.2, p < 0.01) 28 . In different regions of Brazil in 2020 they found a roughly 10% ( p < 0.01) increased prevalence of diabetes among patients with COVID‐19 compared to those suggesting diabetes could both increase risk of getting COVID‐19 and the outcome associated 37 …”

“…28 In different regions of Brazil in 2020 they found a roughly 10% (p < 0.01) increased prevalence of diabetes among patients with COVID-19 compared to those suggesting diabetes could both increase risk of getting COVID-19 and the outcome associated. 37 There are studies that suggest there can be a bitemporal association between diabetes and COVID- The proposed mechanism of diabetes stems beyond just that of COVID-19, but also includes worsening outcomes and increased contraction of upper respiratory infections (URIs). 14,15 Diabetes impairs the body's ability to amount an immune response from constant and chronic inflammation and damage to blood vessels.…”