ABSTRACT
Background: Diabetes has often been indicated as one of the comorbidities in COVID-19 patients. Although infection with COVID-19 primarily affects the lungs causing respiratory complications, other organs are affected including the liver and kidney. The purpose of this study was to determine the effects of diabetes status, liver function and kidney function on COVID-19 severity and length of hospital stay. Methods: This retrospective study used medical records from patients admitted to the University Medical Center, El Paso, TX with COVID-19 (n = 754;age 54.86 ± 0.63 years;BMI 30.07 ± 0.26 Kg/m2). Diabetes status was assessed by glycated hemoglobin (HbA1c) ≥ 6.5%. Liver and Kidney functions were measured by Aspartate transaminase (AST;normal Female/Male 14-36/ 17-59 U/L) and blood urea nitrogen (BUN;normal Female/Male 7-17/ 9-20 mg/dl). Severity of COVID-19 was measured by quick sepsis-related organ failure assessment (qSOFA) and length of hospitalization was determined by the number of days spent in the hospital. Groups were compared using unpaired t-test. Results: Patients with high AST levels had greater COVID-19 severity, measured by qSOFA (high: 0.35 ± 0.03 vs. normal: 0.81 ± 0.05;p = 0.002) and greater length of hospital stay (high: 7.79 ± 0.54 vs. normal 6.35 ± 0.45 days;p = 0.04). Patients with high BUN levels also had greater COVID-19 severity, measured by qSOFA (high: 0.37 ± 0.04 vs. normal: 0.24 ± 0.021;p = 0.001) and greater length of hospital stay (high: 8.83 ± 0.57 vs normal: 5.89 ± 0.38;p < 0.0001). However, patients with diabetes were not different in terms of severity (qSOFA: Non-diabetes 0.34 ± 0.05, vs. Diabetes 0.28 ± 0.03;p = 0.30) and length of hospital stay (Non-diabetes 8.15 ± 0.74, vs. Diabetes 8.88 ± 0.61 days;p = 0.47). Conclusions: Liver and Kidney dysfunction indicates increased severity and length of hospital stay in COVID-19 patients while diabetes status did not. Early detection and supportive interventions that are protective of kidney and liver function may help reduce severity of COVID-19.