THE EFFECT OF DIABETES LEVEL OF CONTORL ON COVID-19 SEVERITY AND MORTALITY: A RETROSPECTIVE COHORT STUDY

Dr. Nada Bassam Rabie*, Dr. Muneera Abdulmalik Alshareef, Dr. Samia Abdullah Bokhari, Dr. Abdullah M. Mallisho, Dr. Turki Abdulaziz Alharthi, Dr. Ghada Asim Rayes, Dr. Waleed Omar Bawazeer, Dr. Rehab Mahmoud Elboraie, Dr. Ameera Husseian Alzahrani, Dr. Hamdy Abdelwareth Alkady, Dr. Mohamed Sayed Galal and Hanin Abdulhameed Shalaby

ABSTRACT

Introduction: Since the beginning of COVID-19 pandemic, diabetes has been recognized to have important impact on the overall disease outcomes, including mortality. Exactly how this effect can vary according to the level of diabetes control is still unclear. Method: We conducted a retrospective cohort study to examine the association between disease outcome in terms of COVID-19 severity and mortality and the level of diabetes control. We collected data on baseline characteristics, HbA1C level, the total basal and bolus insulin and any previous documented complication such as diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemia (HHS). We compared the diabetes control before and after COVID infection. Results: 154 patients were included in our study. Mean age was 59.85 and 56% were males. Even in patients with Good/Fair diabetes control (HbA1C <8%), more than half presented with moderate CVOID-19 severity. Fasting blood sugar was elevated in 66%. While none developed HHS, 2% developed DKA. The mean length of hospital stay was 8 days. Even though mortality rate didn’t vary across various levels of diabetes control, the need of insulin infusion was more in non-survivors (33% vs 4% in survivors, p-value 0.04). Conclusion: Our study clearly demonstrates that diabetes among hospitalized patients with COVID-19 puts them at higher risk of morbidity and mortality. This was especially associated with uncontrolled fasting hyperglycemia (>7mmol/L). Effective measures such as implementation of hyperglycemia algorithm for hospitalized patients and follow up plan should be implemented.

Keywords: COVID-19, diabetes mellitus control, SARS-CoV-2, COVID-19 severity.