Clinical characteristics and short term outcomes after recovery from COVID-19 in patients with and without diabetes in Bangladesh

Abstract

Background and aims This study investigated the clinical manifestations, outcomes and long-term complications of COVID-19 inpatients in Bangladesh while emphasizing on individuals having diabetes. Methods A cross-sectional study was conducted for a sample of COVID-19 inpatients across four different hospitals of Bangladesh between April 1st and June 30, 2020. Variation in clinical characteristics, contact history, comorbidities, treatment pattern, and long-term complications were investigated. Results There were 734 COVID-19 presentations in this study of which 19.8% of patients had diabetes and 76% of the COVID-19 patients were male. Among biochemical parameters, glucose, D-dimer, C- reactive protein (CRP) and Troponin levels were significantly elevated amidst the cohort with diabetes. The frequency of patients requiring insulin increased threefold during infection with SARS CoV2. A number of COVID-19 patients with diabetes have been suffering from long term complications post-recovery including pain, discomfort, memory loss and sleep disturbance. Conclusion Individuals with diabetes have experienced a severe manifestation of COVID-19 and post disease complications. Further in-depth studies focused on larger sample sizes are entailed to assess the relationships elaborately.

Assessment of the Frequency and Variety of Persistent Symptoms Among Patients With COVID-19

“…Three studies excluded patients who were unable or unwilling to receive a magnetic resonance imaging scan. 27 , 35 , 37 Fourteen studies 8 , 14 , 16 , 19 , 23 , 25 , 27 , 29 , 32 , 35 , 37 , 38 , 44 , 45 did not report reasons for nonparticipation and/or the corresponding number of individuals excluded (eTable 4 in the Supplement ).…”

“…Time zero was defined as diagnosis or symptom onset in 16 studies, 10 , 11 , 22 , 24 , 27 , 31 , 33 , 35 , 37 , 39 , 40 , 41 , 45 , 47 , 48 , 50 hospital admission in 4 studies, 9 , 18 , 25 , 46 hospital discharge in 23 studies, 12 , 14 , 15 , 16 , 17 , 19 , 20 , 21 , 23 , 26 , 28 , 29 , 30 , 32 , 36 , 38 , 42 , 43 , 45 , 48 , 49 , 51 , 52 and recovery from acute illness in 4 studies. 8 , 13 , 34 , 44 Two studies used different time zero definitions for outpatients vs inpatients within the same study. 45 , 48 Follow-up duration was similarly variable.…”

“…Data extracted included study and patient characteristics, selection criteria, length of follow-up, and outcome measurements ( Table 1 ). 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 We used 6 quality criteria based on the National Institutes of Health Quality Assessment Tool for Observational and Cohort Studies 53 to assess study design or features most likely to bias frequency estimates. Criteria comprised (1) prospective cohort (score range of 0-1, with 0 indicating no and 1 indicating yes), (2) representativeness (score range of 0-1, with 0 indicating sampling strategy unclear or nonconsecutive enrollees and 1 indicating patients were randomly selected or all eligible patients were included), (3) baseline severity of illness reported (score range of 0-1, with 0 indicating not reported and 1 indicating reported), (4) attrition (score range of 0-3, with 0 indicating not reported or attrition ≥30%, 1 indicating attrition of 20%-29%, 2 indicating attrition of 10%-19%, and 3 indicating attrition <10%), (5) repeated outcome measureme...…”

Clinical characteristics and outcomes of COVID-19 infected diabetic patients admitted in ICUs of the southern region of Bangladesh

“…In a study that included diabetic COVID-19 patients of Bangladesh, Akter et al. (2020) found that propensity of COVID-19 was significantly higher in diabetic patients aged over 40 years [ 23 ]. Consistent with the aforementioned study, this study also found that COVID-19 patients who required ICU support were older and were mostly have diabetes mellitus.…”

Impacto do Diabetes Mellitus sobre o prognóstico da Covid-19

“…Os riscos de desenvolver a forma letal da COVID-19 ou de uma maior necessidade de entrada em Unidades de Terapia Intensiva (UTI) se mostraram extremamente elevados em uma população diabética na Escócia quando comparada aos indivíduos sem a comorbidade (Gurnaghan et al, 2020) e, além de experimentarem manifestações graves da patogenia do SARS-Cov-2, um estudo retrospectivo realizado em Bangladesh relatou uma série de complicações pós COVID-19 em pacientes com DM, incluindo dor, desconforto e distúrbios relacionados ao sono, pressupondo-se que as reações envolvendo coexistência da patologia podem não se limitarem ao período de internação. (Akter et al, 2020).…”