Clinical characteristics and outcomes of COVID-19 infected patients with type 2 diabetes mellitus / 中华内分泌代谢杂志

ABSTRACT

Objective:To observe the main clinical features and outcomes of type 2 diabetes mellitus patients after infection with COVID-19 and to compare them with those without diabetes mellitus.Methods:A single-center retrospective observational study was conducted in 88 in-patients who were diagnosed as COVID-19 from January 1 to February 26, 2020. They were divided into diabetic group and non-diabetic group, with 44 patients in each group. Patients′ medical history, laboratory examination, in-hospital treatment plan, and disease outcome were collected and compared.Results:The clinical symptoms of diabetic patients were varied, mainly fever(75.0%), cough(75.0%), fatigue(52.3%), and so on. The systolic blood pressure(SBP)was higher [131.50(120.00, 140.75) vs 125.00(120.00, 131.75)mmHg, 1 mmHg=0.133 kPa, P=0.021] and the oxygenation was lower [96.00%(94.25%, 97.00%) vs 97.00%(95.00%, 98.00%), P=0.038] at admission compared with the non-diabetic group. Hypertension and chronic kidney disease were more common in diabetic group. Fasting blood glucose [7.64(6.12, 15.43) vs 5.62(5.25, 6.50)mmol/L, P<0.01], interleukin-6(IL-6)[19.85(6.50, 43.38) vs 10.80(3.03, 20.90)pg/ml, P=0.046] in diabetic group were significantly higher than those in non-diabetic group. Secondary infection(27.3% vs 9.1%, P=0.027), ARDS(22.7% vs 4.5%, P=0.013)and shock(4.5% vs 0%, P<0.01)were more likely to occur in the diabetic group. More patients were treated with mechanical ventilation in the diabetic group(20.5% vs 4.5%, P=0.024). The diabetes group was more likely to progress to critical type(20.5% vs 4.5%, P=0.024), and the time to progress to critical state was shorter [3(1.75, 5.25) vs 6(3.00, 12.00)d, P=0.019). The duration of severe symptoms was longer in the diabetic group [26.5(15.00, 31.50) vs 9(8.00, 13.00)d, P=0.026]. Conclusion:The clinical symptoms of type 2 diabetes patients with COVID-19 are diverse. They are often combined with diseases such as hypertension and chronic kidney disease. The inflammatory reaction is more obvious and has more COVID-19 related complications and is more likely to progress into a persistent severe condition in a short time.