Diabetes mellitus as an independent predictor of COVID-19 outcomes

Abstract

Introduction: COVID-19 is a respiratory disease that can range from asymptomatic to critical or fatal. The severity of the clinical presentation depends on various factors, including comorbidities such as diabetes, which has been shown to be strongly associated with a more severe course and higher mortality rate.

Objectives: This study aims to describe the particularities of COVID-1 infection in diabetic patients, and analyze its prognostic implications.

Methods: This retrospective cross-sectional study analyzed all admitted patients with confirmed COVID-19 in the emergency department of the Farhat Hached University Hospital in Sousse from April 1, 2020, to December 31, 2021.

Results: Out of the 2106 COVID-19 patients, 688 (32.66%) had diabetes. Among these patients, diabetes was pre-existing in 88.1% of cases, while it was inaugural in 11.9%. Our study revealed that diabetes was a poor prognostic factor in COVID-19 cases, associated with up to 1.72 (95% CI 1.41-2.1) times greater risk of severe or fatal forms. This may be due to several factors associated with the diabetic population, including advanced age (p=0.001), the presence of underlying comorbidities (p=0.001), and the presence of hemodynamic instability upon admission (p=0.001).  they also exhibited an increased risk of respiratory acidosis (p=0.001) and AKI (p=0.0001). outcomes were less favorable in diabetic patients, with a final hospital mortality rate of 33.9% vs 22.9% in non-diabetic patients (p=0.0001).

Conclusion: Diabetes is one of the comorbidities most associated with the severity of COVID-19 infection. Careful management of diabetic patients with COVID-19 is essential to prevent complications and reduce adverse outcomes.