Long-Term Outcomes of COVID-19 in Hospitalized Type 2 Diabetes Mellitus Patients

Author:

Khamidullina Zemfira1,Avzaletdinova Diana1,Gareeva Diana2,Morugova Tatyana1,Lakman Irina3ORCID,Kopp Kristen4ORCID,Fiedler Lukas5ORCID,Motloch Lukas J.467,Zagidullin Naufal2ORCID

Affiliation:

1. Department of Endocrinology, Bashkir State Medical University, Lenin Str. 3, 450008 Ufa, Russia

2. Department of Internal Medicine, Bashkir State Medical University, Lenin Str. 3, 450008 Ufa, Russia

3. Laboratory for the Study of Socio-Economic Problems of the Regions, Ufa University of Science and Technology, Z. Validi Str. 32, 450076 Ufa, Russia

4. Clinic for Internal Medicine II, Paracelsus Medical University, Muellner Hauptstrasse 48, 5020 Salzburg, Austria

5. Department of Internal Medicine, Cardiology, Nephrology and Intensive Care Medicine, Hospital Wiener Neustadt, 2700 Wiener Neustadt, Austria

6. Department of Internal Medicine II, Salzkammergut Klinikum, OÖG, 4840 Voecklabruck, Austria

7. Department of Cardiology, Kepler University Hospital, Medical Faculty, Johannes Kepler University, 4040 Linz, Austria

Abstract

With the onset of the coronavirus pandemic, it has become clear that patients with diabetes are at risk for more severe and fatal COVID-19. Type 2 diabetes mellitus (T2D) is a major risk factor for adverse COVID-19 outcomes. The goal of study was to assess the characteristics and outcomes of hospitalized patients with COVID-19 with or without T2D in the hospital and at 10-month follow-up (FU). Methods: A total of 2486 hospitalized patients in the first wave of COVID-19 were analyzed according to the absence/presence of T2D, with 2082 (84.1%) patients in the control COVID-19 group and 381 (15.5%) in the T2D group. Twenty-three patients had other types of diabetes and were therefore excluded from the study. In-hospital mortality and cardiovascular endpoints (myocardial infarction, stroke, cardiovascular deaths and hospitalizations and composite endpoints) at the 10-month follow-up were analyzed. To remove bias in patients’ characteristics disproportion, Propensity Score Matching (PSM) was used for hospital and follow-up endpoints. Results. Hospital mortality was considerably greater in T2D than in the control COVID-19 group (13.89% vs. 4.89%, p < 0.0001), and the difference remained after PSM (p < 0.0001). Higher glucose-level T2D patients had a higher mortality rate (p = 0.018). The most significant predictors of hospital death in T2D patients were a high CRP, glucose, neutrophils count, and Charlson Comorbidity Index. The follow-up of patients over 10 months showed a non-significant increase for all endpoints in the T2D group (p > 0.05), and significant increase in stroke (p < 0.042). After the PSM, the difference decreased in stroke (p = 0.090), but became significant in cardiovascular hospitalizations (p = 0.023). Conclusion. In T2D patients with COVID-19, an increase in hospital mortality, stroke and cardiovascular hospitalizations rates in the follow-up was observed.

Funder

Russian Science Foundation

Publisher

MDPI AG

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