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Patients with T2DM had elevated blood sugar, but there were no notable differences between surviving and non-surviving patients with T2DM.
Patients with diabetic nephropathy or a combination of diabetes and obesity have a significantly higher risk of mortality from COVID-19, according to a study published in the Journal of Community Hospital Internal Medicine Perspectives recently reported.
Diabetic nephropathy, also called diabetic nephropathy, is a serious kidney complication of type 1 diabetes (T1D) and type 2 diabetes (T2D).
“Various conditions have been reported as predictors of an adverse outcome in COVID-19 patients,” the study authors said, adding that “the most severe cases appear to occur in the elderly or in patients with distinct comorbidities, in particular cardiovascular disease or diabetes ”.
Besides COVID-19, the authors noted that T2DM is also a risk factor in patients infected with other viruses such as influenza, respiratory syncytial virus, SARS-coronavirus, and MERS-coronavirus.
According to the study, diabetic nephropathy and the combination of T2DM and obesity had the highest COVID-19 death rate of any risk factor studied, at over 70%. “Important laboratory results were impaired renal function and lymphopenia, which were significantly pronounced in the group of diabetic patients with a poor prognosis,” said the authors.
The researchers analyzed the laboratory and radiological results of 75 hospitalized COVID-19 patients and their respective comorbidities at the Kliniken Hochfranken Munchberg, a German community hospital. All 75 patients presented with symptoms of COVID-19, including fever, cough and shortness of breath, and were hospitalized at some point between March 2020 and August 2020.
The average age was 74.2 years (22-99 years), with 40 men and 35 women. Twenty-three patients did not survive (30.7%) and 11 patients were treated in the hospital’s intensive care unit (ICU), including 10 patients in intensive care requiring mechanical ventilation. The mean age of the patients who survived was 71 years while the non-survivors were significantly older at 81.6 years (P <0.0005); the death rate among men was higher than among women (37.5% versus 22.9%; P = 0.315).
A total of 26 patients with COVID-19 had T2DM. Patients with T2DM alone had an increased mortality rate (46.2%), but patients with T2DM and any organ complications associated with diabetes were at higher risk (57.9%). Specifically, patients with diabetic nephropathy had the highest percentage of non-survivors (73.3%, P = 0.0082), obesity being the second highest risk factor (71.4%, P = .0155).
Patients with COVID-19 and congestive heart failure or chronic kidney disease also had an increased risk of mortality, at 57.9% and 56%, respectively.
The study also showed that surviving patients with T2DM required significantly prolonged hospital treatment compared to patients without T2DM (22.3 days vs 11 days; P = .0096).
Blood glucose was elevated in patients with T2DM (P <0.001), but there were no notable differences in blood glucose levels between surviving and non-surviving patients with T2DM. Renal function was impaired in surviving and non-surviving patients with T2DM. Lymphocyte count and glomerular filtration rate were also significantly altered in non-surviving patients with COVID-19 and T2DM.
“As an impact of blood glucose levels on radiologic findings in COVID-19 has been discussed previously, we analyzed and compared the chest computed tomography (CT) images obtained from our patients,” the authors said. observed no striking difference when comparing diabetic patients to the nondiabetic group. “
Reference
Schiller M, Solger K, Leipold S, Kerl HU, Kick W. Nephropathy and obesity associated with diabetes influence the outcome of COVID-19 in patients with type 2 diabetes. J Med Perspect Community Hospitals Intern. Published online September 20, 2021. doi: 10.1080 / 20009666.2021.1957555
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