Clinical characteristics and outcomes of coronavirus disease 2019 infections among diabetics: A retrospective and multicenter study in China

Abstract

Background: Coronavirus disease 2019 (COVID-19) emerged in December 2019 and has spread globally. Diabetics are at increased risk of infections caused by a variety of pathogens including viruses. The present research aims to describe clinical characteristics and outcomes of COVID-19 patients with diabetes. Methods: A retrospective multicenter study of COVID-19 patients with diabetes was conducted in four hospitals in Wuhan, Shanghai, and Anhui Province. Reverse transcription polymerase chain reaction or next-generation sequencing was carried out to confirm the existence of severe acute respiratory syndrome coronavirus 2 from respiratory specimens. Results: A total of 54 diabetics (10.36%) were recruited from among 521 COVID-19 patients, with a median age of 63 (interquartile range, 52-70) years. Among them, 51 had been previously diagnosed with diabetes and 3 had been newly diagnosed based on glycosylated hemoglobin over 6.5%. For COVID-19, 47 of the 54 patients had an exposure history. Fever (47/54, 87.04%), dry cough (36/54, 66.67%), and expectoration (21/53, 39.62%) were among the top three symptoms. Lung infiltration was bilateral (46/52, 88.46%) and multilobe (47/52, 90.38%), and ground-glass opacity (36/37, 97.30%) was the most common pattern in radiological images. Moreover, COVID-19 patients with diabetes were prone to be classified as severe or critical cases (46.30%, 25/54) and had complications such as acute lung injury, acute Huahua Yi, Fangying Lu, and Xiaoyan Jin contributed equally to this work.

Proportion of newly diagnosed diabetes in COVID‐19 patients: A systematic review and meta‐analysis

“…Table 1 presents the characteristics of the included studies. All eight studies were retrospective cohort studies, consisting of four from China, 4,[29][30][31] two from Italy 25,26 and two from the United States. 27,28 All studies were conducted during the first 5 months of the pandemic (i.e.…”

“…A total of eight studies were included in the final analysis 4,[25][26][27][28][29][30][31] (see Figure S2 for the PRISMA flow diagram). Table 1 presents the characteristics of the included studies.…”

“…Data on new-onset diabetes were available in two studies 4,31 and three studies (or cohorts) had previously undiagnosed diabetes cases. 4,28,30 In six studies (or cohorts), 4,[25][26][27][28][29] HbA1c was not performed for all participants, so it was not possible to differentiate between new-onset and previously undiagnosed diabetes. In the majority of studies (n = 6), [25][26][27][28]30,31 the exact time of detection of newly diagnosed diabetes was not reported, whereas, in two studies, 4,29 the diagnosis was made within 24 hours to 3 days after hospital admission.…”

Type 2 diabetes is associated with increased risk of critical respiratory illness in patients COVID-19 in a community hospital

“…Zhu et al [ 10 ] found that patients with diabetes needed more medical interventions and had more frequent multiple organ injury events than patients without diabetes. Huahua et al [ 11 ] found that patients with diabetes and COVID-19 developed more severe disease, had more complications (such as ARDS and AKI), required ICU admission more often, and had higher mortality than patients without diabetes. Sardu et al [ 12 ] also support similar findings.…”

Current understanding of the impact of COVID-19 on gastrointestinal disease: Challenges and openings

“…In view of the significant multifaceted effects of the pandemic, especially in chronic diseases, liver damage can be highly variable and complex, leading to the activation of an intra-hepatic immune response, triggering microvascular thrombosis, hepatic obstruction and systemic inflammation in addition to drug toxicity. In conjunction, this systemic disorder is often associated with a phenomenon known as “bystander hepatitis” and the patient can have a lethal course and show no specific signs of hepatic failure[ 101 , 102 ]. The personal care of these patients relies greatly on the regional COVID-19 prevalence and the laws and guidelines imposed[ 101 ].…”