The relationship between diabetes and clinical outcomes in COVID-19: a single-center retrospective analysis

Tamaryn Fox, Kathleen Ruddiman, Kevin Bryan Lo, Eric Peterson, Robert DeJoy 3rd, Grace Salacup, Jerald Pelayo, Ruchika Bhargav, Fahad Gul, Jeri Albano, Zurab Azmaiparashvili, Catherine Anastasopoulou, Gabriel Patarroyo-Aponte, Tamaryn Fox, Kathleen Ruddiman, Kevin Bryan Lo, Eric Peterson, Robert DeJoy 3rd, Grace Salacup, Jerald Pelayo, Ruchika Bhargav, Fahad Gul, Jeri Albano, Zurab Azmaiparashvili, Catherine Anastasopoulou, Gabriel Patarroyo-Aponte

Abstract

Aims: Coronavirus disease 19 (COVID-19) has become a pandemic. Diabetic patients tend to have poorer outcomes and more severe disease (Kumar et al. in Diabetes Metab Syndr 14(4):535-545, 2020. https://doi.org/10.1016/j.dsx.2020.04.044 ). However, the vast majority of studies are representative of Asian and Caucasian population and fewer represent an African-American population.

Methods: In this single-center, retrospective observational study, we included all adult patients (> 18 years old) admitted to Einstein Medical Center, Philadelphia, with a diagnosis of COVID-19. Patients were classified according to having a known diagnosis of diabetes mellitus. Demographic and clinical data, comorbidities, outcomes and laboratory findings were obtained.

Results: Our sample included a total of 355 patients. 70% were African-American, and 47% had diabetes. Patients with diabetes had higher peak inflammatory markers like CRP 184 (111-258) versus 142 (65-229) p = 0.012 and peak LDH 560 (384-758) versus 499 (324-655) p = 0.017. The need for RRT/HD was significantly higher in patients with diabetes (21% vs 11% p = 0.013) as well as the need for vasopressors (28% vs 18% p = 0.023). Only age was found to be an independent predictor of mortality. We found no significant differences in inpatient mortality p = 0.856, need for RRT/HD p = 0.429, need for intubation p = 1.000 and need for vasopressors p = 0.471 in African-Americans with diabetes when compared to non-African-Americans.

Conclusions: Our study demonstrates that patients with COVID-19 and diabetes tend to have more severe disease and poorer clinical outcomes. African-American patients with diabetes did not differ in outcomes or disease severity when compared to non-African-American patients.

Keywords: COVID-19; Diabetes; Mortality; Novel coronavirus; Outcomes.

Conflict of interest statement

None of the authors have any conflicts of interest to disclose.

Figures

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Fig. 1
Flow diagram for the study

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Source: PubMed

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