Elevated inflammatory markers as predictors of mortality in people with diabetes and COVID-19

Abstract

Introduction: Diabetes Mellitus is a risk factor for COVID-19 infection, however data on specific biomarkers for monitoring the progress and predicting the mortality of diabetic subset of patients admitted with COVID-19is scanty. Our study aims to see the utility of biomarkers in predicting mortality, hospital /ICU stay, necessity of ventilatory support in diabetic patients admitted with COVID-19 infection. Methodology: A retrospective multicentered analysis of data of COVID-19 positive patients who were admitted in two tertiary care hospitals of Kolkata, Eastern India between 1st September 2020 – 15th December 2020 was collected and set which fulfilled the inclusion and exclusion criteria were sent for analysis Results: After accounting for the inclusion and exclusion criteria, a total of 133 subjects’ data (84 males.63.16% and 49 females.36.84%) with mean age of 55.96 ± 11.94 years was available for analysis. Primary outcome viz. mortality was seen in 15 patients (10.9%), whereas the median hospital stays and ICU stay was 10 days and 4 days respectively and a large percentage of patients 47.37 % (63 patients) required ventilatory support. D dimer was the inflammatory marker which had the highest predictive value for mortality, the primary outcome, with an asymptotic significance of <0.001 and the area under the ROC (receiver operator curve) being 1.00. Ferritin, Interleukin -6 and CRP all showed fair to excellent predictability for mortality with the asymptotic significance being < 0.05 for all. Conclusion: Biomarkers namely D-dimer, serum ferritin, C reactive protein (CRP) and interleukin-6 (IL-6) are reliable predictors of mortality in hospitalized COVID-19 patients with diabetes where D dimer showed the highest sensitivity and specificity. Glycated hemoglobin levels did not predict or affect mortality.