Improving outcomes in co-morbid diabetes and COVID-19: A quasi-experimental study (original) (raw)
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Impact of Covid-19 Patients with Diabetes Mellitus and its Association with Clinical Outcomes
Journal of Universal College of Medical Sciences
INTRODUCTION COVID-19 is a debilitating disorder affecting lungs with multiple organs. Diabetes mellitus is considered as a common co-mor- bidity whose impact has not been fully understood. There is a hypothesis that patients with diabetes are at increased risk of severe disease or death due to COVID-19. The main objective of the present study was to find the the association of COVID-19 diabetes mellitus (DM) and non-diabetes mellitus patients with the clinical outcomes. MATERIAL AND METHODS This cross-sectional study was conducted in hospitalized patients with COVID-19 at Universal College of Medical Sciences (UCMS), Bhairahawa. Total of 200 patients were enrolled in the study period from July 2021 to January 2022 whose clinical profile, socio-demographic and biochemical variables were assessed. The study variables taken were symptoms, random blood glucose (RBG), glycosylated hemoglobin (HbA1c) and their outcomes like High Dependency Unit/Intensive Care Unit (HDU/I- CU) or COVID ward...
Study the impact of diabetes outcomes with covid 19 in Rewa
World Journal of Pharmaceutical Sciences, 2022
Eighteen months into the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) (corona virus disease 2019 [COVID-19]) pandemic, epidemiologic studies show that diabetes is a vital contributor to severe COVID-19 morbidity, and, conversely, COVID-19 has had a devastating effect on the population with diabetes. Most cases that have been admitted have been mild to moderate since the early stages of the outbreak. However, there has been an enhance in the number of severe cases and deaths as a outcome of COVID-19, which creates it imperative to evaluate the risk factors for progression of the disease. Current evidence from China and the US recommends that co-morbidities such as hypertension, diabetes, obesity, chronic obstructive pulmonary disease (COPD) and cerebro-vascular disease increase the risk of severity and death from COVID-19. However, there are significant differences in demographic patterns and disease trends between high-income and low-and middle-income countries. COVID-19 infection disrupts glucose regulation, rendering glycemic control difficult and necessitating particularly careful management in patients with diabetes.
South African Medical Journal
The novel coronavirus disease 2019 (COVID-19) was declared an international pandemic by the World Health Organization in March 2020. Since then, it has affected and challenged health systems globally, and continues to do so as we are currently confronted with a resurgence of this virus globally. As of 15 March 2021, there were 120 504 704 confirmed cases, with 2 666 865 confirmed deaths due to COVID-19. [1] Data on the association between diabetes mellitus (DM) and more severe COVID-19 have been well described internationally. [2] Uncontrolled hyperglycaemia was shown to be an independent risk factor for severe disease and mortality in the last three pandemics of influenza A (H1N1), severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) [3-5]-with early evidence also providing extensive links with hyperglycaemia and mortality within the COVID-19 pandemic. [6] Other risk factors, including increasing age, hypertension, cardiovascular disease and obesity have also been associated with more severe COVID-19. [7,8] The prevalence of DM has been increasing globally and South Africa (SA) has not been spared, with some studies estimating a twofold increase in the incidence of type 2 DM from 2000 to 2009 in SA. [9,10] In addition, the International Diabetes Federation suggests that the prevalence of type 2 DM in SA was 12.9% in 2019, with 52.4% of people living with diabetes (PLWD) currently undiagnosed. [11] As SA has a relatively young population, it was uncertain what the consequences would be of the colliding pandemics of COVID-19 and DM. Indeed, an early study by Boulle et al. [12] from the Western Cape Province in SA showed that DM was associated with a 2.4fold increase in mortality when compared with reports from other This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.
Factors associated with the poor outcomes in diabetic patients with COVID-19
Journal of diabetes and metabolic disorders, 2020
Purpose Diabetic's patients are supposed to experience higher rates of COVID-19 related poor outcomes. We aimed to determine factors predicting poor outcomes in hospitalized diabetic patients with COVID-19. Methods This retrospective cohort study included all adult diabetic patients with radiological or laboratory confirmed COVID-19 who hospitalized between 20 February 2020 and 27 April 2020 in Alborz province, Iran. Data on demographic, medical history, and laboratory test at presentation were obtained from electronic medical records. Diagnosis of diabetes mellitus was selfreported. Comorbidities including cancer, rheumatism, immunodeficiency, or chronic diseases of respiratory, liver, and blood were classified as "other comorbidities" due to low frequency. The assessed poor outcomes were in-hospital mortality, need to ICU care, and receiving invasive mechanical ventilation. Self-reported. Multivariate logistic regression models were fitted to quantify the predictors of in-hospital mortality from COVID-19 in patients with DM. Results Of 455 included patients, 98(21.5%) received ICU care, 65(14.3%) required invasive mechanical ventilation, and 79 (17.4%) dead. In the multivariate model, significant predictors of "death of COVID-19" were age 65 years or older (OR (95% CI): 2.0 (1.16-3.44), chronic kidney disease (CKD) (2.05 (1.16-3.62), presence of "other comorbidities" (2.20 (1.04-4.63)), neutrophil count ≥8.0 × 10 9 /L)6.62 (3.73-11.7 ((, Hb level < 12.5 g/dl (2.05 (1.13-3.72) (, and creatinine level ≥ 1.36 mg/dl (3.10 (1.38-6.98)). (All p-values <0.05). Some of these factors were also associated with other assessed poor outcomes, e.g., need to ICU care or invasive mechanical ventilation. Conclusion Diabetic patients with age 65 years or older, comorbidity CKD, "other comorbidities", as well as neutrophil count ≥8.0 × 10 9 /L, Hb level < 12.5 g/dl, and creatinine level ≥ 1.36 mg/dl, were more likely to dead after COVID-19. Presence of hypertension and cardiovascular disease were associated with none of the poor outcomes.
BMJ Open, 2021
Aim This study’s objective was to assess the risk of severe in-hospital complications of patients admitted for COVID-19 and diabetes mellitus (DM). Design This was a cross-sectional study. Settings We used pseudonymised medical record data provided by six general hospitals from the HM Hospitales group in Spain. Outcome measures Multiple logistic regression analyses were used to identify variables associated with mortality and the composite of mortality or invasive mechanical ventilation (IMV) in the overall population, and stratified for the presence or absence of DM. Spline analysis was conducted on the entire population to investigate the relationship between glucose levels at admission and outcomes. Results Overall, 1621 individuals without DM and 448 with DM were identified in the database. Patients with DM were on average 5.1 years older than those without. The overall in-hospital mortality was 18.6% (N=301), and was higher among patients with DM than those without (26.3% vs 11...
Diabetes Research and Clinical Practice, 2020
To describe the clinical characteristics and outcomes of hospitalized COVID-19 patients with diabetes. Methods: A retrospective cross-sectional study was conducted among patients admitted to the William Harvey Hospital in England between March 10th and May10th, 2020 with a laboratory-confirmed severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), known as COVID-19. Variation in characteristics, length of stay in hospital, diabetes status, duration of diabetes, control of diabetes, comorbidities and outcomes were examined. Results: There were 232 COVID-19 presentations. Mean (standard deviation (SD), range) age was 70.5 (±15.7, 30-101) years, 62.5% were male, and 37.5% were having diabetes. There were 43.4% males and 27.6 females, p = 0.016, with diabetes admitted to our hospital due to COVID-19. Patients with diabetes were more likely to have longer length of stay (LOS) in hospital, 14.4 (SD ± 9.6) days, compared to the patients without diabetes, 9.8 (SD ± 17.1) days, p < 0.0001. Patients with diabetic ketoacidosis (DKA) were more likely to survive (87.1%) compared to patients without DKA (50.6%), p = 0.046. Conclusion: Males were more likely to be admitted to hospital with COVID-19 illness than females. Hospitalized COVID-19 patients with diabetes had a longer LOS in hospital than patients without diabetes. Older age COVID-19 patients with diabetes and patients without DKA were less likely to survive compared to younger patients and patients with DKA, respectively. Further studies with large sample size are needed.
COVID-19 in patients with diabetes: factors associated with worse outcomes
Journal of Diabetes & Metabolic Disorders, 2021
Purpose Diabetes is one of the major comorbidities associated with COVID-19. We aimed to determine the clinical and epidemiological factors associated with the mortality of COVID-19 in diabetic patients in Iran, and also the impact of prescribed antiviral and antibiotics on patients' status. Methods In this study, we used the national registry of hospitalized patients with Severe Acute Respiratory Syndrome (SARS) Symptoms with diabetes from February 18, 2020, to December 22, 2020. Demographic, clinical features, treatments, concurrent comorbidities, and their associations with mortality and severity outcomes were assessed using logistic regression. Results 78,554 diabetic in-patients with SARS symptoms were included from 31 provinces of whom 37,338 were PCR positive for COVID-19. Older age and male gender are associated with COVID-19 mortality in diabetic patients. CVD is the most frequent comorbidity (42%). CVD, kidney disease, liver disease, and COPD are associated comorbidities which increased the risk of mortality. The mortality rate is higher in diabetic patients comparing to patients with no comorbidities, particularly in younger age groups. The frequency of antiviral, and antibiotics in COVID-19 positive patients was 34%, and 31%, respectively. Antibiotic treatment has no association with mortality in COVID-19 patients. Conclusions Diabetic patients indicate higher mortality comparing to patients without any underlying comorbidities. Restrict strategies on increasing effective health care utilization must be considered in diabetic patients, especially in those with parallel underlying comorbidities. Regarding the antibiotic resistance issue and the noticeable use of antibiotics in diabetic patients, it is recommended to prioritize an antibiotic guideline prescription in COVID-19 patients for better stewardship by countries.
International Journal of Pharmacy and Pharmaceutical Sciences
Objective: A novel coronavirus infection (SARS-CoV-2) pneumonia (COVID-19) has been quickly spreading throughout China and the rest of the world since December 2019. Respiratory tract infections are frequently linked to diabetes mellitus (DM), a different risk factor. This study has reported the clinical presentation and therapeutic outcomes of COVID-19 with diabetes. Methods: From medical records and histories provided by 72 Covid-19-infected patients with diabetes admitted to the KMCH institute of health sciences and research, Coimbatore, data on demographics, clinical, laboratory, and radiological characteristics as well as treatment outcomes were collected using data collection forms. Real-time reverse transcription polymerase chain reaction (RT-PCR) assay of 2019-CoV RNA was used to screen patients with Covid-19. Results: 72 diabetes patients who tested positive for Covid-19 were admitted for this study. SPSS software version 26 was used to evaluate the data that had been colle...
Covid-19 and diabetes mellitus management
Zenodo (CERN European Organization for Nuclear Research), 2022
In COVID-19, diabetes mellitus is a common comorbidity. For those individuals with COVID-19 and diabetes mellitus, the effect of BG control on treatment requirements and death is still unknown. To that end, we conducted a retrospective analysis involving 7 337 COVID-19 patients from Janakpur Provincial Hospital, Janakpur Dham, Nepal, during April 2021-March 2022, of which 952 already had type 2 diabetes. A greater mortality rate (7.8% versus 2.7%; adjusted hazard ratio [HR], 1.49] and multiple organ injury were detected in patients with diabetes mellitus, as were more medical interventions. For those with well-managed BG (glycemic variability between 3.0 and 10.0 mmol/L), mortality was considerably lower than in those with poorly controlled BG (glycemic variability greater than 10.0 mmol/L) during hospitalization (adjusted HR, 0.14). Patients with COVID-19 and preexisting diabetes mellitus benefit from better glycemic management, according to these data.
TEXILA INTERNATIONAL JOURNAL OF PUBLIC HEALTH, 2022
Coronavirus disease 2019 (Covid-19) pandemic tested the resilience of the health care system in many countries including Zambia. At the peak, disruption of the global supply chain affected availability of essential commodities needed to manage many health ailments like diabetes mellitus (DM). The study was aimed to understand the challenges faced by DM patients in accessing specialist services at KTH DM specialist clinic during the Covid-19 pandemic in 2021. A cross sectional descriptive study was conducted with a total of 293 participants (109 males and 184 females) recruited using a designed structured questionnaire and results analyzed using Microsoft Office Excel 2016 and the Statistical Package for Social Sciences (SPSS) version 16.0 software. The mean age was 54.0 ± 13.0 years old with 78(26.6%) being below the age of 45 years. 197(67.2%) were married and 157(53.6%) had primary education or less. 216(73.7%) and 222(75.8%) were earning <US$5.00 per day before and during Covid-19 pandemic respectively while the majority were spending one fifth of their earned income on medication from private pharmacies alone. 231(78.8%) had T2DM while 149(50.8%) had high plasma glucose levels; high BMI, high waist circumference and hypertension 184(62.8%). The study suggested that disruption of outpatient services led to patients presenting with high plasma glucose levels, poorly controlled weight (high BMI and high waist circumference). Commonest complications included hypertension and peripheral neuropathy. There is a need to devise a more pragmatic and resilient healthcare system in future to minimize the effects of any pandemic should they arise.