The clinical profile and associated mortality in people with and without diabetes with Coronavirus disease 2019 on admission to acute hospital services

Krishna Gokhale, Samiul A. Mostafa*, Jingya Wang, Abd A. Tahrani, Christopher Andrew Sainsbury, Konstantinos A. Toulis, G. Neil Thomas, Zaki Hassan‐Smith, Elizabeth Sapey, Suzy Gallier, Nicola Jaime Adderley, Parth Narendran, Srikanth Bellary, Tom Taverner, Sandip Ghosh, Krishnarajah Nirantharakumar, Wasim Hanif

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: To assess if in adults with COVID-19, whether those with diabetes and complications (DM+C) present with a more severe clinical profile and if that relates to increased mortality, compared to those with diabetes with no complications (DM-NC) and those without diabetes. Methods: Service-level data was used from 996 adults with laboratory confirmed COVID-19 who presented to the Queen Elizabeth Hospital Birmingham, UK, from March to June 2020. All individuals were categorized into DM+C, DM-NC, and non-diabetes groups. Physiological and laboratory measurements in the first 5 days after admission were collated and compared among groups. Cox proportional hazards regression models were used to evaluate associations between diabetes status and the risk of mortality. Results: Among the 996 individuals, 104 (10.4%) were DM+C, 295 (29.6%) DM-NC and 597 (59.9%) non-diabetes. There were 309 (31.0%) in-hospital deaths documented, 40 (4.0% of total cohort) were DM+C, 99 (9.9%) DM-NC and 170 (17.0%) non-diabetes. Individuals with DM+C were more likely to present with high anion gap/metabolic acidosis, features of renal impairment, and low albumin/lymphocyte count than those with DM-NC or those without diabetes. There was no significant difference in mortality rates among the groups: compared to individuals without diabetes, the adjusted HRs were 1.39 (95% CI 0.95–2.03, p = 0.093) and 1.18 (95% CI 0.90–1.54, p = 0.226) in DM+C and DM-C, respectively. Conclusions: Those with COVID-19 and DM+C presented with a more severe clinical and biochemical profile, but this did not associate with increased mortality in this study.

Original languageEnglish
Article numbere00309
JournalEndocrinology, Diabetes & Metabolism
Early online date3 Dec 2021
DOIs
Publication statusE-pub ahead of print - 3 Dec 2021

Bibliographical note

© 2021 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Keywords

  • COVID-19
  • complications
  • diabetes

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