Clinical characteristics and outcomes of COVID-19 diabetic versus non-diabetic patients: A retrospective comparative study

BACKGROUND AND OBJECTIVE: Coronavirus disease-19 (COVID-19) has caused significant morbidity and mortality worldwide. Diabetes mellitus (DM) and related comorbidities have a significant impact on clinical presentation and outcomes. The aim is to compare clinical presentation and outcomes among COVID-19 patients with or without DM. SUBJECTS AND METHODS: Data from 312 patients who tested positive for COVID-19 at a single hospital were collected respectively from January to April 2021. It included demographic data, clinical symptoms, underlying comorbidities, clinical chemistry, and hematological laboratory findings. Different inflammation indices were calculated. The findings of COVID-19 diabetic and non-diabetic patients were compared. RESULTS: The percentage of COVID-19 patients with DM and hypertension or cardiovascular diseases was significantly higher compared to non-diabetic patients (78.6 % vs. 35%, and 46.4% vs. 23%, p < 0.001) respectively. The diabetic patients showed a significant increase in D-dimer and alkaline phosphatase levels (1922.2 vs.1154.5, p = 0.007 and 85.3 vs.75.5, p = 0.01) respectively. On the other hand, diabetic patients showed a significant decrease in serum albumin (3.5 vs.3.6, p = 0.012). The mean death probability indicator (ANDC), and ICU admission were higher in diabetic patients (72.2%, and 36.6%;respectively) versus the non-diabetic patients (60.7% and 26.1%;p < 0.001, 0.071;respectively). Also, the estimated glomerular filtration rate (eGFR) was significantly higher in diabetic patients as compared to non-diabetic patients. CONCLUSION: The diabetic patients had more comorbidities, a higher rate of ICU admission.

The use of prognostic nutritional index (PNI) and selected inflammatory indicators for predicting malnutrition in COVID-19 patients: A retrospective study.

BACKGROUND: Malnutrition causes diverse alterations in the immune system, and COVID-19 is an infection affecting the immune system, consequently leading to malnutrition. AIMS: This study aimed to investigate the use of prognostic nutritional index (PNI) and selected inflammatory indices for malnutrition screening among COVID-19 hospitalized patients. MATERIAL AND METHODOLOGY: This is a single-center retrospective study that enrolled 289 hospitalized COVID-19 patients between 1st January to 30th April 2021, their median age was 59 years. Demographic and biochemical data were collected from patients' records. The PNI, platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and an early warning score to predict mortality risk (ANDC) were calculated. Univariate and multivariate logistic regression analyses were performed. A P-value of < 0.05 was considered statistically significant. RESULTS: about 30 % of patients were admitted to the intensive care unit (ICU), and ICU patients had significantly higher levels of white blood cell (WBCs) count, neutrophils, C-reactive protein (C-RP), and D-dimer (P < 0.05). On the other hand, they had significantly lower levels of lymphocytes and serum albumin (P < 0.001; for both). Those with high ANDC scores were more likely to develop severe conditions affecting nutritional status compared to non-ICU (OR = 1.04, 95 % CI:1.014-1.057; P < 0.001). ANDC showed good discrimination ability with an AUC of 0.784 (cut-off value > 68.19 score). CONCLUSION: It is suggested that ANDC could be used as a predictor for nutritional status and severity in COVID-19 hospitalized patients.

Using inflammatory indices for assessing malnutrition among COVID-19 patients: A single-center retrospective study.

BACKGROUND: Coronavirus disease 2019 (COVID-19) causes malnutrition in infected patients. This study aimed to investigate the use of systemic immune-inflammatory index (SII), platelet-to-lymphocyte ratio (PLR), the Glasgow Prognostic Score (GPS), and neutrophil-to-lymphocyte ratio (NLR) for malnutrition assessment among COVID-19 inpatients. METHODS: This is a single-center retrospective study on 108 hospitalized COVID-19 patients; 14 were admitted to the intensive care unit (ICU). Data were collected from patients' profiles while NLR, PLR, GPS, and SII were calculated. Inflammatory indices' predictive power was analyzed using the receiver operating characteristic curve (ROC). A P-value of < 0.05 was considered statistically significant. RESULTS: Hospitalization days, neutrophils count, C-reactive protein (CRP), and serum urea levels were significantly higher in ICU patients. None of SII, PLR, and NLR were significantly different between ICU and non-ICU groups. Also, albumin and GPS showed a higher sensitivity level (100.0), followed by PLR and SII (78.57 and 71.34, respectively). Regarding ROC curves, even though NLR, PLR, and SII provided the largest area under the curve (AUC) (0.687, 0.682, 0.645; respectively), they have shown a poor discrimination ability, while GPS and albumin were ineffective in predicting malnutrition in COVID-19 patients. CONCLUSION: NLR, SII, and PLR showed poor predicting ability for malnutrition among COVID-19 inpatients. Additional consideration should be taken for using inflammatory parameters (SII, PLR, GPS, and NLR) to predict malnutrition in COVID-19 inpatients.

Impact of COVID-19 Lockdown on Body Weight, Eating Habits, and Physical Activity of Jordanian Children and Adolescents.

OBJECTIVE: The lockdown for the COVID-19 pandemic affects lifestyle patterns globally and impacts children and adolescents. This study aims to assess the effect of the lockdown on body weight, eating habits, and physical activity of Jordanian youth (children and adolescents). METHODS: A cross-sectional study was conducted on a sample of 477 Jordanian children and adolescents aged 6-17 y. The study tool was a structured validated questionnaire. It comprised 4 parts, including a general description of the study purpose, sociodemographic and anthropometric data, physical activity data, and food intake pattern. Questions were reported before and during lockdown. Changes in outcomes over the 2 study time points were evaluated. RESULTS: After the lockdown period, the mean body weight and body mass index for age Z-scores (BAZ) showed a significant increase (P < 0.001) compared with before the lockdown period. More than 50% of the subjects reported that they spent more than 3 h in front of the screen during the lockdown. The percent of subjects who watched TV for more than 3h was increased. Moreover, physical inactivity was increased significantly during the lockdown. All food groups consumption was significantly increased during the lockdown compared to before the lockdown. CONCLUSIONS: COVID-19 lockdown period was characterized by an increase in the use of screen-based devices, lower physical activity, uncontrolled food intake, and weight gain.