Clinical characteristics and outcomes of COVID-19 in patients with type

Abstract

Background Coronavirus disease 2019 (COVID-19) has been reported to be associated with a more severe course in patients with type 2 diabetes mellitus (T2DM). However, severe adverse outcomes are not recorded in all patients. In this study, we assessed disease outcomes in patients with and without T2DM hospitalized for COVID-19.

Methods A nationwide retrospective cohort of patients with T2DM hospitalized with confirmed COVID-19 infection from 11 March to 30 May 2020 in the Turkish Ministry of Health database was investigated. Multivariate modeling was used to assess the independent predictors of demographic and clinical characteristics with mortality, length of hospital stay, and intensive care unit (ICU) admission and/or mechanical ventilation.

Results A total of 18 426 inpatients (median age [interquartile range, IQR]: 61 [17] years; males: 43.3%) were investigated. Patients with T2DM (n = 9213) were compared with a group without diabetes (n = 9213) that were matched using the propensity scores for age and gender. Compared with the group without T2DM, 30-day mortality following hospitalization was higher in patients with T2DM (13.6% vs 8.7%; hazard ratio 1.75; 95% CI, 1.58-1.93; P < .001). The independent associates of mortality were older age, male gender, obesity, insulin treatment, low lymphocyte count, and pulmonary involvement on admission. Older age, low lymphocyte values, and pulmonary involvement at baseline were independently associated with longer hospital stay and/or ICU admission.

Conclusions The current study from the Turkish national health care database showed that patients with T2DM hospitalized for COVID-19 are at increased risk of mortality, longer hospital stay, and ICU admission.

C1 [Sonmez, Alper] Univ Hlth Sci Turkey, Gulhane Fac Med, Dept Endocrinol & Metab, Ankara, Turkey.

[Sonmez, Alper; Tasci, Ilker] Gulhane Training & Res Hosp, Ankara, Turkey.

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

[Tasci, Ilker] Univ Hlth Sci Turkey, Gulhane Fac Med, Dept Internal Med, Ankara, Turkey.

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

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

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

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

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

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

[Atmaca, Aysegul] Samsun 19 Mayis Univ, Dept Endocrinol & Metab, Fac Med, Samsun, Turkey.

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

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

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

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

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

[Satman, Ilhan] Turkish Inst Publ Hlth & Chron Dis, Istanbul, Turkey.