Clinical characteristics and outcomes of COVID-19 patients with diabetes mellitus in Kuwait

Abstract

Background COVID-19 has a highly variable clinical presentation, ranging from asymptomatic to severe respiratory symptoms and death. Diabetes seems to be one of the main comorbidities contributing to a worse COVID-19 outcome. Objective In here we analyze the clinical characteristics and outcomes of diabetic COVID-19 patients Kuwait. Methods In this single-center, retrospective study of 417 consecutive COVID-19 patients, we analyze and compare disease severity, outcome, associated complications, and clinical laboratory findings between diabetic and non-diabetic COVID-19 patients. Results COVID-19 patients with diabetes had more ICU admission than non-diabetic COVID-19 patients (42.4% vs. 7.7%, p < 0.001). Diabetic COVID-19 patients also recorded higher mortality in comparison to non-diabetic COVID-19 patients (34.7% vs. 3.7%, p < 0.001). Diabetic COVID-19 patients had significantly higher prevalence of comorbidities, such as hypertension. Laboratory investigations also highlighted notably higher levels of C-reactive protein in diabetic COVID019 patients and lower estimated glomerular filtration rate. They also showed a higher incidence of complications. logistic regression analysis showed that every 1 mmol/L increase in fasting blood glucose in COVID-19 patients is associated with 1.52 (95% CI: 1.34–1.72, p < 0.001) times the odds of dying from COVID-19. Conclusion Diabetes is a major contributor to worsening outcomes in COVID-19 patients. Understanding the pathophysiology underlining these findings could provide insight into better management and improved outcome of such cases.

Robust Antibody Levels in Both Diabetic and Non-Diabetic Individuals After BNT162b2 mRNA COVID-19 Vaccination

“…To date, more than 190 million people worldwide have been diagnosed with COVID-19, with an overall prevalence rate of at least 2% (1). Although, mortality rates are generally lower (2.2%), the presence of preexisting health conditions such as T2DM, hypertension, cardiovascular disease, and metabolic syndrome may contribute to increased case fatality rates up to 10% (2)(3)(4). A myriad of factors may contribute to increased susceptibility of T2DM patients for developing COVID-19 complications, including impaired innate/adaptive immunity, after the onset of a state of chronic, low-grade inflammation called metabolic inflammation.…”

Risk of mortality among inpatients with COVID‐19 and type 2 diabetes: National data from Kuwait

“…One recent study specifically in people with type 2 diabetes in Kuwait suggests that diabetes patients with COVID‐19 have poor clinical prognosis. 10 …”

“…This raises the question of whether diabetes is a particular risk factor for poor COVID‐19 outcomes in the Middle East, since the severity and prevalence of type 2 diabetes is distinct in this area of the world. One recent study specifically in people with type 2 diabetes in Kuwait suggests that diabetes patients with COVID‐19 have poor clinical prognosis 10 …”

Association of serum C-reactive protein (CRP) and D-dimer concentration on the severity of COVID-19 cases with or without diabetes: a systematic review and meta-analysis

“…Oxygen saturation (SpO2 < 90%) is significantly decreased in these types of patients indicating that CRP levels are increased in severe lung injury patients [ 66 ]. Increased CRP were reported in 13 studies [ 37 , 38 , 40 , 43 , 47–49 , 51 , 54 , 61–64 ], where patients were separated into two groups: diabetic and non-diabetic. This result showed that increased CRP was highly associated with severe conditions of diabetic patients.…”