Clinical characteristics and outcomes of COVID‐19 in patients with type 2 diabetes in Turkey: A nationwide study (TurCoviDia)

Abstract

Background Coronavirus disease 2019 (COVID‐19) has been reported to be associated with a more severe course in patients with type 2 diabetes mellitus (T2DM). However, severe adverse outcomes are not recorded in all patients. In this study, we assessed disease outcomes in patients with and without T2DM hospitalized for COVID‐19. Methods A nationwide retrospective cohort of patients with T2DM hospitalized with confirmed COVID‐19 infection from 11 March to 30 May 2020 in the Turkish Ministry of Health database was investigated. Multivariate modeling was used to assess the independent predictors of demographic and clinical characteristics with mortality, length of hospital stay, and intensive care unit (ICU) admission and/or mechanical ventilation. Results A total of 18 426 inpatients (median age [interquartile range, IQR]: 61 [17] years; males: 43.3%) were investigated. Patients with T2DM (n = 9213) were compared with a group without diabetes (n = 9213) that were matched using the propensity scores for age and gender. Compared with the group without T2DM, 30‐day mortality following hospitalization was higher in patients with T2DM (13.6% vs 8.7%; hazard ratio 1.75; 95% CI, 1.58‐1.93; P < .001). The independent associates of mortality were older age, male gender, obesity, insulin treatment, low lymphocyte count, and pulmonary involvement on admission. Older age, low lymphocyte values, and pulmonary involvement at baseline were independently associated with longer hospital stay and/or ICU admission. Conclusions The current study from the Turkish national health care database showed that patients with T2DM hospitalized for COVID‐19 are at increased risk of mortality, longer hospital stay, and ICU admission.

COVID-19 and diabetes: a deadly duo?

“…Based on those results diabetes has been hailed as a risk factor for poor early outcome in COVID-19 pa-tients. A longer observation period of 30 days yielded comparable results and conclusions since the mortality was significantly higher in patients with type 2 diabetes than in the group without (13.6% vs 8.7%; p < 0.001) as reported by Sonmez et al [11]. Moreover, pre-diabetes and undiagnosed type 2 diabetes were also found to be risk factors for severe SARS-CoV-2 infection [8].…”

“…According to these results, the length of hospitalization was not affected by the presence of diabetes. Contrastingly, in a nationwide study based on the Turkish Ministry of Health database, Sonmez et al [11] reported a significantly higher rate of prolonged hospitalization, defined as a hospital stay of more than 8 days, among 9,213 patients with type 2 diabetes. The median length of hospital stay in the entire study population of 18,426 patients hospitalized for COVID-19 was 8 days.…”

Clinical outcomes of non-diabetic COVID-19 patients with different blood glucose levels: a nationwide Turkish study (TurCoGlycemia)

“…Many studies reported that diabetes mellitus, especially T2DM, is one of the most frequent comorbidities in COVID-19 patients [10,11,[13][14][15]. The findings also indicated that hyperglycemic state in patients is very important in the prognosis of COVID-19 disease.…”

“…This nationwide study was conducted using the COVID-19 registry of the Turkish Ministry of Health National Electronic Database. To promote data sharing with the scientific society, demographic, clinical, and outcome data of all symptomatic confirmed cases of COVID-19 infection were made available to the author group under the supervision of the Ministry of Health, and several publications have been made so far [10,11]. The study population included 149,671 adult patients with confirmed COVID-19 (PCR positive) diagnosis from 11 March through 30 May 2020.…”

Clinical Outcomes of Non-diabetic COVID-19 Patients with Different Blood Glucose Levels: A Nationwide Turkish Study (TurCoGlycemia)

“…Moreover, recent data indicate that new-onset hyperglycemia is common among hospitalized author group under the supervision of the Ministry of Health, and several publications have been made so far. [10,11] The study population included 149,671 adult patients with con rmed COVID-19 (PCR positive) diagnosis from 11 March through 30 May 2020. Figure 1 illustrates the patient enrollment.…”