Demographic and clinical features of critically ill patients with COVID-19 in Greece: The burden of diabetes and obesity

P Halvatsiotis; A Kotanidou; K Tzannis; E Jahaj; E Magira; M Theodorakopoulou; G Konstandopoulou; E Gkeka; C Pourzitaki; N Kapravelos; S Papoti; M Sileli; C Gogos; D Velissaris; N Markou; E Stefanatou; G Vlachogianni; E Aimoniotou; A Komnos; T Zafeiridis; P Koulouvaris; A Armaganidis; A Bamias; G Dimopoulos

doi:10.1016/j.diabres.2020.108331

Demographic and clinical features of critically ill patients with COVID-19 in Greece: The burden of diabetes and obesity

Diabetes Res Clin Pract. 2020 Aug:166:108331. doi: 10.1016/j.diabres.2020.108331. Epub 2020 Jul 17.

Authors

P Halvatsiotis¹, A Kotanidou², K Tzannis³, E Jahaj², E Magira², M Theodorakopoulou⁴, G Konstandopoulou⁴, E Gkeka⁵, C Pourzitaki⁵, N Kapravelos⁶, S Papoti⁶, M Sileli⁶, C Gogos⁷, D Velissaris⁸, N Markou⁹, E Stefanatou⁹, G Vlachogianni¹⁰, E Aimoniotou¹¹, A Komnos¹², T Zafeiridis¹², P Koulouvaris¹³, A Armaganidis¹⁴, A Bamias¹⁵, G Dimopoulos¹⁶

Affiliations

¹ 2nd Propaedeutic Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Rimini 1, Chaidari 124 62, Greece. Electronic address: pahalv@gmail.com.
² 1st Department of Critical Care, Medical School of National and Kapodistrian University of Athens, "EVANGELISMOS" General Hospital, 45-47 Ipsilantou str, 10675 Athens, Greece.
³ 2nd Propaedeutic Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Rimini 1, Chaidari 124 62, Greece.
⁴ 2nd Department of Critical Care, Medical School of National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Rimini 1, Chaidari 124 62, Greece.
⁵ Department of Anesthesiology and Intensive Care, Faculty of Medicine, School of Health Sciences of Aristotle University of Thessaloniki, AHEPA University Hospital, Kyriakidi 1, Thessaloniki 54621, Greece.
⁶ 2nd Critical Care Department, General Hospital of Thessaloniki "G. PAPANIKOLAOU" Leof. Papanikolaou, Pilaia Chortiatis 57011, Greece.
⁷ Emergency Department and Department of Internal Medicine of Patras University, Medical School, University Hospital of Patras, Rio, Patras 26504, Greece. Electronic address: cgogos@med.upatras.gr.
⁸ Emergency Department and Department of Internal Medicine of Patras University, Medical School, University Hospital of Patras, Rio, Patras 26504, Greece.
⁹ LATSION Burn Center - Intensive Care Unit, General Hospital of Eleusis "THRIASSIO", Leof G Gennimata, Elefsina 19600, Greece.
¹⁰ Department of Critical Care, AGIOS DIMITRIOS General Hospital of Thessaloniki, Elenis Zografou 2, Thessaloniki 54634, Greece. Electronic address: glykav@otenet.gr.
¹¹ Department of Critical Care, AGIOS DIMITRIOS General Hospital of Thessaloniki, Elenis Zografou 2, Thessaloniki 54634, Greece.
¹² Department of Critical Care, General Hospital of Larisa "KOUTLIMPANIO", Tsakalof 1, Larisa 41221, Greece.
¹³ 1st Department of Orthopaedics, Medical School of National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Rimini 1, Chaidari 124 62, Greece. Electronic address: info@drkoulouvaris.gr.
¹⁴ 2nd Department of Critical Care, Medical School of National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Rimini 1, Chaidari 124 62, Greece. Electronic address: aarmag@med.uoa.gr.
¹⁵ 2nd Propaedeutic Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Rimini 1, Chaidari 124 62, Greece. Electronic address: abamias@med.uoa.gr.
¹⁶ 2nd Department of Critical Care, Medical School of National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Rimini 1, Chaidari 124 62, Greece. Electronic address: gdimop@med.uoa.gr.

Abstract

Aims: The aim of the study was to investigate the association between type-2 diabetes mellitus, other underlying diseases and obesity with the outcomes of critically ill Covid-19 patients in Greece.

Methods: In this retrospective observational multi-centre study, data and outcomes of 90 RNA 2109-nCoV confirmed critically ill patients from 8 hospitals throughout Greece, were analysed. All reported information stand through April 13th 2020.

Results: The median age of the patients was 65.5 (IQR 56-73), majority were male (80%) and obesity was present in 34.4% of patients most prevalent to younger than 55 years. Hypertension was the prevailing comorbidity (50%), followed by cardiovascular diseases (21.1%) and type-2 diabetes (18.9%). At admission, common symptoms duration had a median of 8 (IQR 5-11) days. A 13.3% of the patients were discharged, 53.4% were still in the ICUs and 28.9% deceased who were hospitalised for fewer days than the survivors [6 (IQR 3-9) vs. 9 (IQR 7-14.5) respectively]. Aging was not a risk factor but diabetes deteriorates the outcomes. Obesity poses a suggestive burden as it was more notable in deceased versus survivors.

Conclusions: Type 2 diabetes and obesity may have contributed to disease severity and mortality in COVID-19 critically ill patients in Greece.

Keywords: Covid-19; Critically ill; Greece; Intensive Care Unit; Obesity; Type-2 diabetes.

Publication types

Multicenter Study
Observational Study

MeSH terms

Aged
Betacoronavirus / isolation & purification*
COVID-19
Comorbidity
Coronavirus Infections / complications
Coronavirus Infections / epidemiology
Coronavirus Infections / mortality*
Coronavirus Infections / virology
Critical Illness / mortality*
Diabetes Mellitus / mortality*
Diabetes Mellitus / physiopathology
Diabetes Mellitus / virology
Female
Greece / epidemiology
Hospitalization
Humans
Male
Middle Aged
Obesity / mortality*
Obesity / physiopathology
Obesity / virology
Pandemics
Pneumonia, Viral / complications
Pneumonia, Viral / epidemiology
Pneumonia, Viral / mortality*
Pneumonia, Viral / virology
Prognosis
Retrospective Studies
Risk Factors
SARS-CoV-2
Survival Rate