Type 2 diabetes is associated with increased risk of critical respiratory illness in patients COVID-19 in a community hospital

Autor: Aswin Ratna Kansakar, Ekta Shrestha, Guillermo Rodriguez Nava, Clio Musurakis, Prasun Pudasainee, Mariam Charkviani, Harvey J. Friedman, Alisha Sharma, Shanmugha Padhamanbhan, Amrit Devkota, Solab Chitrakar, Mina Sous, Rabin Banjade
Jazyk: angličtina
Rok vydání: 2020
Předmět:
0301 basic medicine
endocrine system diseases
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Respiratory failure
law.invention
CAD
Coronary artery disease
0302 clinical medicine
law
Intubation
COVID-19
Coronavirus disease 2019
Incidence (epidemiology)
Hazard ratio
GI
gastrointestinal
Intensive care unit
Community hospital
Type 2 Diabetes
PCT
Procalcitonin
DLCO
Diffusion capacity for carbon monoxide
CK
Creatinine kinase
CRP
C-reactive protein
medicine.medical_specialty
030209 endocrinology & metabolism
COPD
Chronic obstructive pulmonary disease
ACE2
angiotensin-converting enzyme 2
Article
WHO
World Health Organization
VTE
Venous thromboembolism
03 medical and health sciences
Internal medicine
ICU
Intensive Care Unit
ARDS
Acute respiratory distress syndrome
Internal Medicine
medicine
HbA1c
Glycated hemoglobin
Medical history
IL-6
Interleukin-6
Survival analysis
030109 nutrition & dietetics
CHF
Congestive heart failure
business.industry
SARS-CoV-2
Public Health
Environmental and Occupational Health
AKI
Acute kidney injury
nutritional and metabolic diseases
COVID-19
IQR
Interquartile range
CKD
Chronic kidney disease
SARS-CoV-2
Severe acute respiratory syndrome virus 2
business
human activities
ESR
Erythrocyte sedimentation rate
Zdroj: Obesity Medicine
ISSN: 2451-8476
Popis: Background Type 2 diabetes (T2D) is the leading non-communicable disease worldwide and is associated with several microvascular and macrovascular complications. Individuals with T2D are more prone to acquiring selected types of infections and are more susceptible to complications due to these infections. This study aimed to evaluate the relationship between T2D and COVID-19 in the community setting. Methods This was a single-center retrospective analysis that included 147 adult patients with laboratory-confirmed COVID-19 admitted to a community hospital. Demographics, medical history, symptoms and signs, laboratory findings, complications during the hospital course, and treatments were collected and analyzed. The Kaplan-Meier method was used to describe the probability of intubation in patients with T2D as compared with patients without T2D. The hazard ratio for intubation in the survival analysis was estimated using a bivariable Cox proportional-hazards model. Results Of 147 patients, 73 (49.7%) had a history of T2D. Patients with T2D had higher requirement of ICU admission (31.5% vs 12.2%; p=.004), higher incidence of ARDS (35.6% vs 16.2%, p=.007), higher rates of intubation (32.9% vs 12.2%, p=0.003), and higher use neuromuscular blocking agents (23.3% vs 9.5%, p=.02). In the survival analysis at 28 days of follow-up, patients with T2D showed an increased hazard for intubation (HR 3.00; 95% CI, 1.39 to 6.46). Conclusion In our patient population, patients with COVID-19 and T2D showed significantly higher ARDS incidence and intubation rates. The survival analysis also showed that after 28 days of follow-up, patients with T2D presented an increased risk for shorter time to intubation.
Highlights • Individuals with diabetes are more prone to infections and complications due to these infections. • Patients with COVID-19 and diabetes had higher ARDS incidence and intubation rates. • These patients also presented an increased risk for shorter time to intubation compared to patients without diabetes.
Databáze: OpenAIRE
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