Abstract
Diabetes is an important comorbidity of COVID-19. This study aimed to compare the clinical course and outcomes of COVID-19 patients with and without diabetes. We enrolled 321 hospitalized patients with COVID-19 from the Third Xiangya Hospital (Hunan, China) between December 20, 2021, and March 1, 2021, including 158 patients with diabetes and 163 patients without diabetes. Data from medical records, including clinical characteristics, coexisting conditions, complications, laboratory tests, radiographic studies, treatments and outcomes, were extracted and analyzed. Among COVID-19 patients with type 2 diabetes, several biochemical parameters, such as systolic blood pressure [137.00 (IQR: 122.00-148.50) vs. 126.00 (IQR: 116.00-137.00), P<0.001], CRP [64.25 (IQR: 28.16-129.83) vs. 44.13 (IQR: 17.56-87.26), P = 0.005], PCT [0.11 (IQR: 0.06-0.44) vs. 0.08 (IQR : 0.05-0.14), P = 0.002], urea nitrogen [15.40 (IQR 10.62-24.44) vs. 10.34 (IQR:7.56-15.14), P < 0.001), In terms of clinical symptoms, patients with diabetes had pleural effusion [17.3% vs. 7.5%, P=0.010], fever [39.0% vs. 60.7%, P<0.001], and nausea and vomiting [10.4% vs. 1.2%, P<0.001], and fatigue symptoms [22.7% vs 12.9%, P=0.022]. There were significant differences in comorbidities, including hypertension (71.2% vs. 37.0%, P<0.001) and chronic kidney disease (6.4% vs. 18.5%, P=0.001). The statistically significant difference in treatment between COVID-19 patients with diabetes and those without diabetes was mainly reflected in the use of azvudine (15.9% vs. 40.7%, P<0.001). Regression analysis revealed that the lymphocyte ratio (0R=0.925, 95% CI 0.885-0.966, P<0.001) and age (0R=1.025, 95% CI 1.003-1.048, P=0.027) had a statistically significant effect on the severity of respiratory failure. Some clinical symptoms and medication differences had statistically significant effects on survival time, including calcification (HR=0.410, 95% CI 0.193-0.872, P=0.021), pleural effusion (HR=1.935, 95% CI 1.259-2.975, P=0.003), diabetes (HR=1.416, 95% CI 1.042-1.926, P=0.026), chronic kidney disease (HR=1.557, 95% CI 1.032-2.349, P=0.035), use of antibiotics (HR=1.623, 95% CI 1.139-2.315, P=0.007) and glucocorticoids (HR=1.623, 95% CI 1.139-2.315, P=0.005), and use of mechanical ventilation (HR=4.201, 95% CI 1.883-9.377, P<0.001). Our study suggested that COVID-19 patients with diabetes tend to have more severe disease and poorer clinical outcomes, and this relationship requires further exploration.Retrospectively registered.