Characteristics, Mortality, and Clinical Outcomes of Hospitalized Patients with COVID-19 and Diabetes: A Reference Single-Center Cohort Study from Poland

Abstract

Background. Diabetes is a risk factor for a severe course of COVID-19. We evaluated the characteristics and risk factors associated with undesirable outcomes in diabetic patients (DPs) hospitalized due to COVID-19. Materials and Methods. The data analysis of patients admitted between March 6, 2020, and May 31, 2021, to the University Hospital in Krakow (Poland), a reference center for COVID-19, was performed. The data were gathered from their medical records. Results. A total number of 5191 patients were included, of which 2348 (45.2%) were women. The patients were at the median age of 64 (IQR: 51–74) years, and 1364 (26.3%) were DPs. DPs, compared to nondiabetics, were older (median age: 70 years, IQR: 62–77 vs. 62, IQR: 47–72, and p < 0.001) and had a similar gender distribution. The DP group had a higher mortality rate (26.2% vs. 15.7%, p < 0.001) and longer hospital stays (median: 15 days, IQR: 10–24 vs. 13, IQR: 9–20, and p < 0.001). DPs were admitted to the ICU more frequently (15.7% vs. 11.0%, p < 0.001) and required mechanical ventilation more often (15.5% vs. 11.3%, p < 0.001). In a multivariate logistic regression, factors associated with a higher risk of death were age >65 years, glycaemia >10 mmol/L, CRP and D-dimer level, prehospital insulin and loop diuretic use, presence of heart failure, and chronic kidney disease. Factors contributing to lower mortality were in-hospital use of statin, thiazide diuretic, and calcium channel blocker. Conclusion. In this large COVID-19 cohort, DPs constituted more than a quarter of hospitalized patients. The risk of death and other outcomes compared to nondiabetics was higher in this group. We identified a number of clinical, laboratory, and therapeutic variables associated with the risk of hospital death in DPs.

Diabetes as a risk factor of death in hospitalized COVID-19 patients – an analysis of a National Hospitalization Database from Poland, 2020

“…These numbers should be seen in the context that initially, due to a mandatory supervision by epidemiological services or hospitalization related to COVID-19, the number of patients admitted to the hospitals was disproportionately higher, as hospitalization of all patients with SARS-CoV-2 infection was obligatory ( 25 ). Of note, the proportion of DPs among all hospitalized COVID-19 patients identified on the state level was slightly lower than in our earlier report involving a large single center cohort from the University Hospital in Krakow (26,3%) ( 26 ). Still, multiple reasons may contribute to the higher frequency of hospitalizations in patients with comorbidities, including diabetes.…”

COVID-19 outcome among diabetic patients admitted in a tertiary care hospital: An observational study

“…Same findings were reported by a study done in Kuwait [18] . Mortality rate in our study was higher than the reported rate for the UAE [19] and in concordance with another study by kumar A et al, [7] and other studies also [20,21] . Diabetes mellitus was found to negatively impact most of the outcomes analyzed in our study like hospital stay, ICU admission, and mortality were all adversely influenced by the presence of diabetes among covid-19 patients.…”

Diabetes Mellitus and Its Association with Adverse In-Hospital Outcomes in Patients with COVID-19—A Nationwide Study

“…Similar results were reported in a Chinese study in which DM patients with COVID-19 were found to have a 2.95-fold increased risk of death compared to non-diabetics [ 31 ]. Data from other countries also show higher mortality in COVID-19 patients in the presence of DM, including Scotland [ 32 ], Poland [ 33 ], and Saudi Arabia [ 34 ]. A meta-analysis comprising seven studies revealed DM as a significant risk factor for suffering from a severe course of COVID-19 infection, with an increased relative risk of 2.11-fold compared to non-diabetic COVID-19 patients.…”