Clinical Characteristics and outcomes of Diabetic Patients Hospitalized for COVID-19: A Multicenter Cross-Sectional Study in Southwestern Iran

Clinical Characteristics and outcomes of Diabetic Patients Hospitalized for COVID-19: Southwestern Iran

  • Mehrnaz Ahmadi Medical and Surgical Nursing Department, School of Nursing and Midwifery, Nursing Care Research Center in Chronic Disease, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  • Javad Zarei Department of Health Information Technology, School of allied ‎Medical Sciences, Ahvaz ‎Jundishapur University of Medical Science, Ahvaz, Iran
  • Ali Mohammad Hadianfard Department of Health Information Technology, School of allied ‎Medical Sciences, Ahvaz ‎Jundishapur University of Medical Science, Ahvaz, Iran
  • Touba Narimani Moghadam Behbahan Faculty of Medical Sciences
DOI: https://doi.org/10.5937/afmnai40-39949
Ključne reči: COVID-19, dijabetes, smrtnost, prognostički faktori, Iran×

Sažetak


Background: Diabetes is one of the most common diseases among hospitalized patients due to Covid-19. Therefore, this study aimed to identify the clinical characteristics of diabetic patients with COVID-19 that may lead to death.

 

Methods: A Multicenter Cross-Sectional study was conducted among patients admitted to the hospitals due to COVID-19. The data, including demographic data, symptoms and signs, underlying diseases, patient progress, and outcomes, were obtained from 38 hospitals in the registry system of Khuzestan province (the southwest of Iran) between January 19, 2020, and March 8, 2021. The Cox proportional hazards regression was used to analyze the data.

Results: Data from 23,447 hospitalized patients due to COVID-19 were included in the study. 4340 of the participants (18.5%) with a average age of 62 years had diabetes and 14.72% of them death. Multivarible Cox regression showed that the variables of age (Hazard Ratio (HR) = 2.65; 95% CI: 1.78- 3.95; P <0.001), Sex (HR = 1.16; 95% CI: 1.001- 1.35; P =0.049), and comorbidities such as cancer (HR = 1.89; 95% CI: 1.24- 2.89; P =0.003) and cardiovascular disease (HR = 1.2; 95% CI: 1.24-2.89; P =0.032) were associated with mortality in diabetic patients with COVID-19.

Conclusion:

This study showed that COVID-19 mortality was higher in men, the elderly, and people with cardiovascular disease and cancer. Therefore, the management and prevention of COVID-19 in diabetic patients with these characteristics are vital.

 

Reference

Reference


 



  1. Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet (London, England). 2020;395(10224):565-74.

  2. The Omicron variant: sorting fact from myth: WHO 2022 [Available from: https://www.euro.who.int/en/health-topics/health-emergencies/pages/news/news/2022/01/the-omicron-variant-sorting-fact-from-myth.

  3. COVID-19 Coronavirus Pandemic, live update‎: Worldometer‎; 2022 [Available from: https://www.worldometers.info/coronavirus/.

  4. Zali A, Gholamzadeh S, Mohammadi G, Azizmohammad Looha M, Akrami F, Zarean E, et al. Baseline Characteristics and Associated Factors of Mortality in COVID-19 Patients; an Analysis of 16000 Cases in Tehran, Iran. Archives of academic emergency medicine. 2020;8(1):e70.

  5. Parohan M, Yaghoubi S, Seraji A, Javanbakht MH, Sarraf P, Djalali M. Risk factors for mortality in patients with Coronavirus disease 2019 (COVID-19) infection: a systematic review and meta-analysis of observational studies. The aging male : the official journal of the International Society for the Study of the Aging Male. 2020;23(5):1416-24.

  6. Ahmadi A, Ardeshiri S, Nezhadi VR, Pajoohesh A, Moghadam TN, Sabaghan M, et al. Risk Factors for Mortality in Hospitalized Patients with COVID-19: A Cross-Sectional Study in Southwestern Iran. Iranian Red Crescent Medical Journal. 2021;23(9).

  7. Silverii GA, Monami M, Cernigliaro A, Vigneri E, Guarnotta V, Scondotto S, et al. Are diabetes and its medications risk factors for the development of COVID-19? Data from a population-based study in Sicily. Nutrition, Metabolism and Cardiovascular Diseases. 2021;31(2):396-8.

  8. Carrasco-Sánchez FJ, López-Carmona MD, Martínez-Marcos FJ, Pérez-Belmonte LM, Hidalgo-Jiménez A, Buonaiuto V, et al. Admission hyperglycaemia as a predictor of mortality in patients hospitalized with COVID-19 regardless of diabetes status: data from the Spanish SEMI-COVID-19 Registry. Annals of medicine. 2021;53(1):103-16.

  9. Kim EJ, Ha KH, Kim DJ, Choi YH. Diabetes and the Risk of Infection: A National Cohort Study. Diabetes & metabolism journal. 2019;43(6):804-14.

  10. Santos A, Magro DO, Evangelista-Poderoso R, Saad MJA. Diabetes, obesity, and insulin resistance in COVID-19: molecular interrelationship and therapeutic implications. Diabetology & Metabolic Syndrome. 2021;13(1):23.

  11. Rubino F, Amiel SA, Zimmet P, Alberti G, Bornstein S, Eckel RH, et al. New-onset diabetes in Covid-19. New England Journal of Medicine. 2020;383(8):789-90.

  12. Lim S, Bae JH, Kwon H-S, Nauck MA. COVID-19 and diabetes mellitus: from pathophysiology to clinical management. Nature Reviews Endocrinology. 2021;17(1):11-30.

  13. Li J, Wang X, Chen J, Zuo X, Zhang H, Deng A. COVID‐19 infection may cause ketosis and ketoacidosis. Diabetes, Obesity and Metabolism. 2020;22(10):1935-41.

  14. Ren H, Yang Y, Wang F, Yan Y, Shi X, Dong K, et al. Association of the insulin resistance marker TyG index with the severity and mortality of COVID-19. Cardiovascular diabetology. 2020;19(1):1-8.

  15. Weinberger DM, Chen J, Cohen T, Crawford FW, Mostashari F, Olson D, et al. Estimation of excess deaths associated with the COVID-19 pandemic in the United States, March to May 2020. JAMA internal medicine. 2020;180(10):1336-44.

  16. Myers LC, Parodi SM, Escobar GJ, Liu VX. Characteristics of hospitalized adults with COVID-19 in an integrated health care system in California. Jama. 2020;323(21):2195-8.

  17. Shi Q, Zhang X, Jiang F, Zhang X, Hu N, Bimu C, et al. Clinical characteristics and risk factors for mortality of COVID-19 patients with diabetes in Wuhan, China: a two-center, retrospective study. Diabetes care. 2020;43(7):1382-91.

  18. Yan Y, Yang Y, Wang F, Ren H, Zhang S, Shi X, et al. Clinical characteristics and outcomes of patients with severe covid-19 with diabetes. BMJ open diabetes research and care. 2020;8(1):e001343.

  19. Holman N, Knighton P, Kar P, O'Keefe J, Curley M, Weaver A, et al. Risk factors for COVID-19-related mortality in people with type 1 and type 2 diabetes in England: a population-based cohort study. The lancet Diabetes & endocrinology. 2020;8(10):823-33.

  20. Apicella M, Campopiano MC, Mantuano M, Mazoni L, Coppelli A, Del Prato S. COVID-19 in people with diabetes: understanding the reasons for worse outcomes. The lancet Diabetes & endocrinology. 2020;8(9):782-92.

  21. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The lancet. 2020;395(10223):507-13.

  22. Alkundi A, Mahmoud I, Musa A, Naveed S, Alshawwaf M. Clinical characteristics and outcomes of COVID-19 hospitalized patients with diabetes in the United Kingdom: a retrospective single centre study. diabetes research and clinical practice. 2020;165:108263.

  23. Belice T, Demir I. The gender differences as a risk factor in diabetic patients with COVID-19. Iranian Journal of Microbiology. 2020;12(6):625.

  24. Cai H. Sex difference and smoking predisposition in patients with COVID-19. The Lancet Respiratory Medicine. 2020;8(4):e20.

  25. Leung JM, Yang CX, Tam A, Shaipanich T, Hackett T-L, Singhera GK, et al. ACE-2 expression in the small airway epithelia of smokers and COPD patients: implications for COVID-19. European Respiratory Journal. 2020;55(5).

  26. Farsalinos K, Barbouni A, Poulas K, Polosa R, Caponnetto P, Niaura R. Current smoking, former smoking, and adverse outcome among hospitalized COVID-19 patients: a systematic review and meta-analysis. Therapeutic advances in chronic disease. 2020;11:2040622320935765.

  27. Salehidoost R, Mansouri A, Amini M, Aminorroaya Yamini S, Aminorroaya A. Diabetes and all-cause mortality, a 18-year follow-up study. Scientific reports. 2020;10(1):1-8.

  28. Dennis JM, Mateen BA, Sonabend R, Thomas NJ, Patel KA, Hattersley AT, et al. Type 2 diabetes and COVID-19–Related mortality in the critical care setting: a national cohort study in England, March–July 2020. Diabetes care. 2021;44(1):50-7.

  29. Orioli L, Servais T, Belkhir L, Laterre P-F, Thissen J-P, Vandeleene B, et al. Clinical characteristics and short-term prognosis of in-patients with diabetes and COVID-19: a retrospective study from an academic center in Belgium. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2021;15(1):149-57.

  30. Meng Y, Lu W, Guo E, Liu J, Yang B, Wu P, et al. Cancer history is an independent risk factor for mortality in hospitalized COVID-19 patients: a propensity score-matched analysis. Journal of hematology & oncology. 2020;13(1):1-11.

  31. Yang K, Sheng Y, Huang C, Jin Y, Xiong N, Jiang K, et al. Clinical characteristics, outcomes, and risk factors for mortality in patients with cancer and COVID-19 in Hubei, China: a multicentre, retrospective, cohort study. The Lancet Oncology. 2020;21(7):904-13.


 

Objavljeno
2025/12/19
Broj časopisa
Vol. 40 Br. 2 (2023): Acta facultatis medicae Naissensis
Rubrika
Originalni rad / Original article