The Clinical Characteristics and Outcomes of COVID-19 Infections in Patients with Diabetes at a Tertiary Care Center in the UAE

Abstract

<b><i>Introduction:</i></b> Uncontrolled glycemia is a well-recognized predictor of severity and deaths in previous respiratory viral outbreaks. We aimed to describe the characteristics and clinical course of patients with diabetes admitted with COVID-19 infection at a tertiary care center in the Emirate of Dubai, UAE, and assess the impact of hyperglycemia on the clinical outcomes. <b><i>Methods:</i></b> This study is a single-center, observational, retrospective chart review of 250 cases during the months of March to May 2020. <b><i>Results:</i></b> Among the 250 cases studied, 235 (94%) were male. The mean age of the study group was 49.6 ± 10.4 years, with an age range of 21–78 years. Diabetes was previously known in 166 (66.4%) of the patients. The mortality (<i>p</i> = 0.03) and requirement for mechanical ventilation (<i>p</i> = 0.02) were higher for the cases with newly diagnosed diabetes when compared to those with pre-existing diabetes. <b><i>Conclusion:</i></b> Uncontrolled hyperglycemia adversely affects patients with COVID-19 infection. Newly diagnosed and previously undiagnosed hyperglycemia poses an added risk for complications. In the context of the COVID-19 pandemic, optimizing glycemia in hospitalized patients is of paramount importance and screening to detect undiagnosed cases of diabetes may be particularly relevant.

The underlying mechanisms for severe COVID-19 progression in people with diabetes mellitus: a critical review

“…Additionally, studies from London and the US said that nonwhite patients with DM were the majority among COVID-19 cohorts, with 72% and 56%, respectively [40] , [41] . Furthermore, the prevalence of DM in COVID-19 patients has been higher in adults over 50 years of age, especially in those aged 65-70 years [29] , [30] , [33] , [37] , [42] . Other studies indicate that male patients with DM had a significant prevalence (50–60%) among COVID-19 patients [31] , [42] , [43] .…”

“…Furthermore, the prevalence of DM in COVID-19 patients has been higher in adults over 50 years of age, especially in those aged 65-70 years [29] , [30] , [33] , [37] , [42] . Other studies indicate that male patients with DM had a significant prevalence (50–60%) among COVID-19 patients [31] , [42] , [43] . Unfortunately, the association of DM with COVID-19 has usually resulted in severe illness or poor prognosis [21] , [34] , [44] .…”

Clinical Course and Disease Outcome in Covid-19 Patients With Diabetes Mellitus

“…There was significant difference between sex of admitted patients, since the ratio was around 2:1 for males vs. females. But, in similar study led by Hafidh et al, the percent of males with diabetes was 94% 18 . Guo et al, also proved that diabetes was significantly more prevalent in patients who were admitted in intensive care, required mechanical ventilation, with fatal outcome, than in patients who did not have these complications (26.9% vs 6.1%) 19 .…”

“…A study from UAE found mortality of 10% among COVID-19 patients with DM. It also notified that the mortality and requirement for mechanical ventilation were higher for the patients with newly diagnosed DM in comparison with patients who had DM before admission18 . Meta-analysis from Wu et al, found significant relation of mortality inCOVID-19 patients with pre-existing diabetes, OR of 1.75 (95% CI 1.31-2.36; P=0.0002)…”

A Case for Enhancing Coverage of Influenza Vaccination in Gulf Cooperation Council Countries in Patients with Diabetes Mellitus during COVID-19

“…The prevalences of DM and prediabetes in the GCC countries varied between 7.6% to 66.4% among hospitalized COVID-19 patients in Saudi Arabia 14 and the UAE, 15 respectively. The coexistence of DM and COVID-19 was associated with worse outcomes and higher mortality rates.…”