This article is part of Pulmonology Advisor’s coverage of the CHEST Virtual 2020 meeting.
Hospitalized patients with severe coronavirus disease 2019 (COVID-19) and diabetes are less likely to be discharged from the hospital and are more likely to experience in-hospital mortality compared with hospitalized patients with severe COVID-19 and no diabetes, according to research presented at the CHEST Annual Meeting held virtually October 18 to 21.
The findings of this research were based on a retrospective analysis of deidentified data from 115 patients admitted to the intensive care unit for severe COVID-19. Patients were at high risk for complications from their disease, as reflected by their older age (mean age, 63.44 years) and increased body weight (mean body mass index, 33.30). The majority of patients were men (67%), another risk factor for poor COVID-19-related outcomes. On average, patients experienced symptoms for 6.35 days prior to hospitalization. Commonly reported symptoms in this group included dyspnea (81%), cough (75%), and fever (68%).
The study population had a high comorbidity burden, with 68 patients presenting with a Charlson Comorbidity Index of 3 or higher. The most frequently reported comorbidities in these patients were hypertension (65%), diabetes (41%), and hyperlipidemia (35%).
In a comparative analysis between 47 patients with diabetes and 68 patients without diabetes, a similar proportion of patients in both groups required invasive mechanical ventilation (65% vs 51%, respectively). Additionally, 36% of patients with diabetes and 48% of patients without diabetes required noninvasive mechanical ventilation.
No significant differences were found between the 2 groups regarding clinical management. A similar proportion of patients with vs without diabetes experienced shock that required vasopressors (57% vs 48%, respectively) as well as renal failure that required renal replacement therapy (27% vs 25%). In addition, there were no significant differences between patients with vs without diabetes regarding the rate of acute kidney injury (61% vs 40%, respectively) and acute hepatic injury (27% vs 22%). Patients with diabetes, however, did experience higher rates of troponin elevation (89% vs 70%).
Following propensity score matching, the investigators found that patients with diabetes were significantly more likely to experience in-hospital mortality (odds ratio [OR], 2.94; 95% CI, 1.32-6.52; P =.008) and less likely to be discharged from the hospital (OR, 0.38; 95% CI, 0.17-0.83; P =.02).
According to the researchers, additional study examining management strategies of patients with diabetes and “severe COVID-19 may be useful given the increased risk for mortality in this population.”
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Poon J, Ho SK, Herrera Y, Jean R. Clinical outcomes in diabetic vs non-diabetic patients with severe COVID-19. Presented at: the CHEST Virtual Annual Meeting; October 18-21, 2020. Abstract 688.