The outcomes of patients with diabetes mellitus in The Philippine CORONA Study

Abstract

Patients diagnosed with diabetes mellitus (DM) who are infected with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) belong to the most vulnerable patient subgroups. Emerging data has shown increased risks of severe infections, increased in ICU admissions, longer durations of admission, and increased mortality among coronavirus disease 2019 (COVID-19) patients with diabetes. We performed a subgroup analysis comparing the outcomes of patients diagnosed with DM (n = 2191) versus patients without DM (n = 8690) on our data from our study based on a nationwide, comparative, retrospective, cohort study among adult, hospitalized COVID-19 patients involving 37 hospital sites from around the Philippines. We determined distribution differences between two independent samples using Mann–Whitney U and t tests. Data on the time to onset of mortality, respiratory failure, intensive care unit (ICU) admission were used to build Kaplan–Meier curves and to compute for hazard ratios (HR). The odds ratios (OR) for longer ventilator dependence, longer ICU stay, and longer hospital stays were computed via multivariate logistic regression. Adjusted hazard ratios (aHR) and ORs (aOR) with 95% CI were calculated. We included a total of 10,881 patients with confirmed COVID-19 infection (2191 have DM while 8690 did not have DM). The median age of the DM cohort was 61, with a female to male ratio of 1:1.25 and more than 50% of the DM population were above 60 years old. The aOR for mortality was significantly higher among those in the DM group by 1.46 (95% CI 1.28–1.68; p < 0.001) as compared to the non-DM group. Similarly, the aOR for respiratory failure was also significantly higher among those in the DM group by 1.67 (95% CI 1.46–1.90). The aOR for developing severe COVID-19 at nadir was significantly higher among those in the DM group by 1.85 (95% CI 1.65–2.07; p < 0.001). The aOR for ICU admission was significantly higher among those in the DM group by 1.80 (95% CI 1.59–2.05) than those in the non-DM group. DM patients had significantly longer duration of ventilator dependence (aOR 1.33, 95% CI 1.08–1.64; p = 0.008) and longer hospital admission (aOR 1.13, 95% CI 1.01–1.26; p = 0.027). The presence of DM among COVID-19 patients significantly increased the risk of mortality, respiratory failure, duration of ventilator dependence, severe/critical COVID-19, ICU admission, and length of hospital stay.

Incidence and risk factors for stroke in patients with COVID-19 in the Philippines: An analysis of 10,881 cases

“…14 The lesser incidence of stroke among COVID-19 positive healthcare workers may be due to healthy-worker effect bias, i.e., health care workers or employed people, in general, have better health-seeking behavior or annual mandatory health examinations compared to the unemployed or elderly. 18 Similarly, the mortality and hazard rates among COVID-19 stroke patients were higher compared to those with COVID-19 alone. 9,10,19 Compared to western data, COVID-19 stroke patients in our study were 2.17 times more likely and with 3.45 times more likely to die due to several etiologies at a particular time (42.2% vs. 19.4%).…”

Psychotropic drug repurposing for COVID-19: A Systematic Review and Meta-Analysis

“…Also, the possibility of a spurious result concerning the association of AP use and negative COVID-19 outcomes cannot be ruled out. AP show a heterogeneous but significant positive association with metabolic complications ( Pillinger et al, 2020 ; Zhang et al, 2017 ), and the presence of metabolic comorbidities such as diabetes or metabolic syndrome among COVID-19 patients significantly increased the risk of mortality, respiratory failure, duration of ventilator dependence, severe/critical COVID-19, ICU admission, and length of hospital stay ( Denson et al, 2021 ; Espiritu et al, 2021 ).…”

Type 2 Diabetes Mellitus and COVID-19: A Narrative Review

“…So far, different studies have shown that people with T2DM have higher risk of COVID-19 mortality compared with non-diabetic individuals [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. Nevertheless, Al-Salameh et al, reported that COVID-19-related death in patients with T2DM was lower than in general population, but the rate of intensive care unit (ICU) admission was increased [ 20 ].…”