Characteristics and outcomes of COVID-19 in hospitalized patients with and without diabetes

Diabetes Metab Res Rev. 2021 Mar;37(3):e3388. doi: 10.1002/dmrr.3388. Epub 2020 Aug 18.

Abstract

Background: Coronavirus disease 2019 (COVID-19) is a rapidly progressing pandemic, with four million confirmed cases and 280 000 deaths at the time of writing. Some studies have suggested that diabetes is associated with a greater risk of developing severe forms of COVID-19. The primary objective of the present study was to compare the clinical features and outcomes in hospitalized COVID-19 patients with vs without diabetes.

Methods: All consecutive adult patients admitted to Amiens University Hospital (Amiens, France) with confirmed COVID-19 up until April 21st, 2020, were included. The composite primary endpoint comprised admission to the intensive care unit (ICU) and death. Both components were also analysed separately in a logistic regression analysis and a Cox proportional hazards model.

Results: A total of 433 patients (median age: 72; 238 (55%) men; diabetes: 115 (26.6%)) were included. Most of the deaths occurred in non-ICU units and among older adults. Multivariate analyses showed that diabetes was associated neither with the primary endpoint (odds ratio (OR): 1.12; 95% confidence interval (CI): 0.66-1.90) nor with mortality (hazard ratio: 0.73; 95%CI: 0.40-1.34) but was associated with ICU admission (OR: 2.06; 95%CI 1.09-3.92, P = .027) and a longer length of hospital stay. Age was negatively associated with ICU admission and positively associated with death.

Conclusions: Diabetes was prevalent in a quarter of the patients hospitalized with COVID-19; it was associated with a greater risk of ICU admission but not with a significant elevation in mortality. Further investigation of the relationship between COVID-19 severity and diabetes is warranted.

Keywords: acute respiratory distress syndrome; coronavirus disease 2019 (COVID-19); diabetes; intensive care; mortality; outcome.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • COVID-19* / complications
  • COVID-19* / diagnosis
  • COVID-19* / epidemiology
  • COVID-19* / therapy
  • Cohort Studies
  • Comorbidity
  • Diabetes Mellitus / diagnosis*
  • Diabetes Mellitus / epidemiology*
  • Diabetes Mellitus / mortality
  • Diabetes Mellitus / therapy
  • Female
  • France / epidemiology
  • Hospital Mortality
  • Hospitalization / statistics & numerical data*
  • Humans
  • Intensive Care Units / statistics & numerical data*
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Pandemics
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2 / physiology
  • Severity of Illness Index
  • Treatment Outcome