Unexpectedly lower mortality rates in COVID-19 patients with and without

Abstract

Aims: Type 2 diabetes mellitus (T2DM) is a risk factor for severe COVID-19. Our aim was to compare the clinical outcomes of patients with and without T2DM during the first hit of COVID-19 in Istanbul.& nbsp; Methods: A retrospective population-based study was conducted including all consecutive adult symptomatic COVID-19 cases. Patients were confirmed with rt-PCR; treated and monitored in accordance with standard protocols. The primary endpoints were hospitalization and 30-day mortality.& nbsp; Results: Of the 93,571 patients, 22.6% had T2DM, with older age and higher BMI. Propensity Score matched evaluation resulted in significantly higher rates of hospitalization (1.5-fold), 30-day mortality (1.6-fold), and pneumonia (1.4-fold). They revealed more severe laboratory deviations, comorbidities, and frequent drug usage than the Non-DM group. In T2DM age, pneumonia, hypertension, obesity, and insulin-based therapies were associated with an increased likelihood of hospitalization; whereas age, male gender, lymphopenia, obesity, and insulin treatment were considerably associated with higher odds of death.& nbsp; Conclusions: COVID-19 patients with T2DM had worse clinical outcomes with higher hospitalization and 30-day mortality rates than those without diabetes. Compared to most territories of the world, COVID-19 mortality was much lower in Istanbul, which may be associated with accessible healthcare provision and the younger structure of the population.& nbsp; (C)& nbsp;2021 Elsevier B.V. All rights reserved.

C1 [Satman, Ilhan] Istanbul Univ, Fac Med, Dept Internal Med, Div Endocrinol & Metab, Istanbul, Turkey.

[Satman, Ilhan; Arga, Kazim Yalcin] Hlth Inst Turkey, Inst Publ Hlth & Chron Dis, Kosuyolu Caddesi 71, TR-34718 Istanbul, Turkey.

[Demirci, Ibrahim; Haymana, Cem; Sonmez, Alper] Univ Hlth Sci, Gulhane Training & Res Hosp, Dept Internal Med, Div Endocrinol & Metab, Ankara, Turkey.

[Tasci, Ilker; Sonmez, Alper] Univ Hlth Sci, Gulhane Fac Med, Ankara, Turkey.

[Tasci, Ilker] Univ Hlth Sci, Gulhane Training & Res Hosp, Dept Internal Med, Ankara, Turkey.

[Salman, Serpil] Med Clin, Endocrinol & Metab, Istanbul, Turkey.

[Ata, Naim] Minist Hlth, Dept Strategy Dev, Ankara, Turkey.

[Dagdelen, Selcuk; Unluturk, Ugur] Hacettepe Univ, Fac Med, Dept Internal Med, Div Endocrinol & Metab, Ankara, Turkey.

[Sahin, Ibrahim] Inonu Univ, Fac Med, Dept Internal Med, Div Endocrinol & Metab, Malatya, Turkey.

[Emral, Rifat; Sahin, Mustafa] Ankara Univ, Fac Med, Dept Internal Med, Div Endocrinol & Metab, Ankara, Turkey.

[Cakal, Erman] Univ Hlth Sci, Diskapi Yildirim Beyazit Training & Res Hosp, Fac Med, Dept Internal Med,Div Endocrinol & Metab, Ankara, Turkey.

[Atmaca, Aysegul] Ondokuz Mayis Univ, Fac Med, Dept Internal Med, Div Endocrinol & Metab, Samsun, Turkey.

[Celik, Osman] Minist Hlth, Publ Hosp Gen Directorate, Ankara, Turkey.

[Demir, Tevfik] Dokuz Eylul Univ, Fac Med, Dept Internal Med, Div Endocrinol & Metab, Ankara, Turkey.

[Ertugrul, Derun] Univ Hlth Sci, Kecioren Training & Res Hosp, Fac Med, Dept Internal Med,Div Endocrinol & Metab, Ankara, Turkey.

[Arga, Kazim Yalcin] Marmara Univ, Fac Engn, Dept Bioengn, Istanbul, Turkey.

[Caglayan, Murat] Ankara Prov Hlth Directorate, Ankara, Turkey.

[Sonmez, Alper] Univ Hlth Sci, Training & Res Hosp, Dept Internal Med, Div Endocrinol & Metab, Ankara, Turkey.