Clinical characteristics and risk factors for disease severity and mortality of COVID-19 patients with diabetes mellitus in Kazakhstan: A nationwide study

Azhar Dyusupova; Raida Faizova; Oksana Yurkovskaya; Tatiana Belyaeva; Tatiana Terekhova; Amina Khismetova; Antonio Sarria-Santamera; Dmitry Bokov; Alexandr Ivankov; Natalya Glushkova

doi:10.1016/j.heliyon.2021.e06561

Clinical characteristics and risk factors for disease severity and mortality of COVID-19 patients with diabetes mellitus in Kazakhstan: A nationwide study

Heliyon. 2021 Mar;7(3):e06561. doi: 10.1016/j.heliyon.2021.e06561. Epub 2021 Mar 19.

Affiliations

¹ Department of Personalized Medicine, Semey Medical University, Semey, Kazakhstan.
² School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan.
³ Institute of Pharmacy, Sechenov First Moscow State Medical University, Moscow, Russia.
⁴ Laboratory of Food Chemistry, Federal Research Center of Nutrition, Biotechnology and Food Safety, Moscow, Russia.
⁵ Department of Postgraduate Education, Kazakh Medical University of Continuing Education, Almaty, Kazakhstan.
⁶ Department of Epidemiology, Evidence-Based Medicine and Biostatistics, Kazakhstan Medical University Higher School of Public Health, Almaty, Kazakhstan.

Abstract

Background: Diabetes mellitus (DM) is associated with higher risk of developing infectious disease and COVID-19 is not the exception. There is a need to generate more data on clinical characteristics and risks of COVID19 patients presenting with DM. In this retrospective study we aimed to report on demographic features, clinical data, and outcomes of COVID-19 patients with DM in comparison with age- and sex-matched patients without DM.

Methods: This was a retrospective study that relied on the nationwide data on all COVID-19 patients who were diagnosed from 14 March to 18 April, 2020. Overall, there were 31 cases with DM for which we randomly matched 4 patients without DM by age and sex.

Results: COVID-19 patients with associated DM had less beneficial outcomes and more severe disease course both at hospital admission and final diagnosis, as compared with the age and sex-matched non-DM patients. Diabetics were more predisposed to impaired breathing (29.0 % versus 4.9 % in controls), nausea/vomiting (6.5 % versus 0 % in controls) and weakness/lethargy (45.2 % versus 26.0 % in controls). Finally, 48.4 % of diabetics showed the signs of pneumonia on CT scans versus 20.3 % of non-diabetics (p = 0.001), and 32.3 % of DM patients were admitted to intensive care units as compared with just 5.7 % of non-DM patients (p<0.001).

Conclusion: There is a need to envisage early status monitoring and supportive care in this vulnerable category of patients to enable better prognosis.

Keywords: COVID-19; Case-control study; Diabetes mellitus; Kazakhstan; Outcomes.