Phenotypic characteristics and clinical outcome in hospitalized patients with COVID-19 and diabetes

Poposki, Kostadin; Bosilkovski, Mile; Grozdanovski, Krsto; Sopova, Zaklina; Osmani, Arlinda; Jakimovski, Dejan; Georgievska, Dajana; Milenkovic Tatjana

doi:10.37897/rmj.2022.4.6

Phenotypic characteristics and clinical outcome in hospitalized patients with COVID-19 and diabetes

Journal

Romanian Medical Journal

Date Issued

2022-12-31

Author(s)

Sopova, Zaklina

Georgievska, Dajana

DOI

10.37897/rmj.2022.4.6

Abstract

Objectives. The aim is to describe the phenotypic, biological and clinical characteristics of hospitalized patients with COVID-19 and diabetes, and the association with the clinical outcome of the patients. Material and methods. This single-center, retrospective study was conducted on 200 patients. The primary endpoint was death observed within day 7, 14 and beyond day 14 of hospitalization, and secondary objective was to compare the survival group with non-survival group. The variables that demonstrated significant association with primary endpoint were subject to multivariate binary logistic regression analysis. Outcomes. The estimated prevalence was 17.87% of the total COVID-19 hospitalizations during this period (n=1119). The majority of the patients were with diabetes mellitus type 2 with a median age of 67 years and BMI of 27.8 kg/m2. On admission, 156 patients (78%) presented with severe/critical illness. A total of 93 patients (46.5%) met the primary endpoint, with most deaths occurring within day 7 of hospital stay. Non-survival group showed significantly higher levels of leucocytes count, more pronounced lymphopenia, higher CRP, LDH and D-dimer levels. Multivariate analysis identified four independent risk factors associated with death: age OR 1.05 (CI 95% 1.01-1.09), severity of disease at admission OR 0.22 (CI 95, 0.07-0.65), COVID-19 vaccination status OR 3.07 (CI 95%, 1.36-6.91) and LDH levels OR 1.00 (CI 95%,1.002-1.008). Conclusions. Diabetic patients admitted to hospital for COVID-19 infection tend to have high mortality rate. Severity of disease at admission, advanced age, not completed vaccination and increased LDH levels are independent risk factors for lethal outcome, irrespective of diabetes status.

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