ABSTRACT
Background and Aims: Glycaemic control during a COVID- 19 pneumonia is affected by illness severity and required therapeutic measures (e.g. corticosteroids) in patients with diabetes. The aim is to compare glycaemic control and therapeutic changes during the inpatient stay in patients with HbA1c <7.0% compared to those with ≥7.0 on admission. Methods: Clinical data of 59 patients with diabetes, who were hospitalized between October 15th-December 31th 2020 at our pulmonary department due to a COVID-19 illness, were retrospectively collected and stratified according to their metabolic control at admission (HbA1c<7.0% or ≥7.0%) Results: Compared to patients with sufficient metabolic control (HbA1c<7.0%,n = 24), patients with HbA1c≥7.0% (n = 35) had longer duration of diabetes (p = 0.013), were more often male (74%vs.46%,p = 0.032) and were more frequently treated with metformin (74%vs.46%,p = 0.032) and DDP4- inhibitors (34%vs.8%, p = 0.029). The average glucose on admission (175vs.225mg/dl) worsened during inpatient stay in both groups. Patients with higher baseline HbA1c consistently showed higher glucose values during their stay (299vs.205mg/dl, p <0.001). Insulin requirement increased in both groups, whereby the maximum insulin dose per day over observation period was 13 IU in patients with baseline HbA1c<7.0% and 52 IU in patients with HbA1c≥7.0% (p < 0.001). In contrast, there was no difference in hospital mortality (17%vs.26%,p = 0.529). Using logistic regression, the patient's age was identified as a significant risk factor for hospital mortality (OR:1.07, 95%CI:1.01-1.14, p = 0.034). Conclusions: Patients with diabetes, particularly those with HbA1c ≥7.0 on admission, and severe COVID-19 disease show a significant deterioration in their glycaemic control during their inpatient stay. Increasing age in patients with diabetes is associated with a higher risk of mortality.
ABSTRACT
Patients with asthma should be vaccinated against COVID-19. This includes patients with severe asthma. Treatment with a biological for asthma is no contra-indication for vaccination against COVID-19.