DIABETES CONTRIBUTES IN INCREASING RISK OF MORBIDITY AND MORTALITY RELATED TO COVID-19 DURING PATIENTS’ HOSPITALIZATION

Mohamed Ebsaim*, Husni Alraheem, Fathia G. Jaat, Ettiyeb Lagha, Sheama Algemi, Moudah Jamoum, Yasmen Aldobali and Ali S. Arebie

ABSTRACT

Background: diabetes mellitus is a complex chronic disease characterized by glucose dysregulation and is associated with significant complications. It is considered one of the most important risk factors for a severe course of COVID-19. Diabetes comorbidities such as increased risk of severe pneumonia and a more pronounced pro-inflammatory response and hypercoagulability or pro-thrombotic status in patients with COVID-19 during hospitalization can be associated with disease deterioration with poor outcomes even death. Aim: to determine the effect of diabetes on hospitalized patients diagnosed with COVID-19. Materials and methods: In this retrospective cohort study, 85 critically ill COVID-19 patients with an age ranging between 34-90 years admitted to the ICU in the isolation centres were selected to perform this research during the period from September 2020 to May 2021. Patients were classified based on the history of diabetes mellitus disease into 47 diabetic, and 38 non-diabetic COVID-19 patients. Routine laboratory tests include haematological, inflammatory, coagulation and renal function biomarkers were collected three times from all patients, upon admission and continued throughout the hospitalization stay. Results: Patients with DM had higher WBCs and neutrophils counts and lower lymphocytes counts than non-diabetic, which were statistically significant (P<0.05). As long as the diabetic patient stayed longer in the ICU, the WBCs and NEU count were getting higher and LYM getting lower. In diabetic COVID-19 patients, glucose was positively significant correlated with WBC and NEU and negatively significant with lymphocytes (P<0.05). CRP, ESR and D-dimer levels were increased abnormally in all patients, but were significant only among diabetic COVID-19 patients (P<0.001). A strong positive significant relation was seen between the sugar and CRP (r=0.367 and P=0.023), and D-dimer (r=0.314 & P=0.032) in diabetic patients, while no relation was seen in non-diabetic patients. Urea and creatinine increased significantly in diabetic rather than in non-diabetic patients (P<0.05), their levels continued in increase as long as the diabetic patients remained longer in the ICU. Patients with DM had greater mortality rate compared to patients without diabetes (66% vs 23.7%). Conclusion: diabetes and hyperglycaemia are associated with poor outcomes and increased mortality rate among hospitalized COVID-19 patients. Therefore, regulate glucose levels in COVID19 patients may improve disease outcomes and diminish the mortality rate.

Keywords: ? Diabetes Mellitus ? Corona Virus ? Hospitalised Patients ? Morbidity and Mortality.