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1.
J Med Virol ; 93(12): 6660-6670, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1544317

ABSTRACT

With the wide spread of Coronavirus, most people who infected with the COVID-19, will recover without requiring special treatment. Whereas, elders and those with underlying medical problems are more likely to have serious illnesses, even be threatened with death. Many more disciplines try to find solutions and drive master plan to this global trouble. Consequently, by taking one particular population, Hungary, this study aims to explore a pattern of COVID-19 victims, who suffered from some underlying conditions. Age, gender, and underlying medical problems form the structure of the clustering. K-Means and two step clustering methods were applied for age-based and age-independent analysis. Grouping of the deaths in the form of two different scenarios may highlight some concepts of this deadly disease for public health professionals. Our result for clustering can forecast similar cases which are assigned to any cluster that it will be a serious cautious for the population.


Subject(s)
COVID-19/epidemiology , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Asthma/complications , COVID-19/etiology , Diabetes Complications/epidemiology , Female , Humans , Hungary/epidemiology , Lung Diseases/complications , Male , Middle Aged , Neoplasms/complications , Obesity/complications , Risk Factors , Schizophrenia/complications , Sex Factors , Young Adult
2.
Clin Appl Thromb Hemost ; 27: 10760296211045902, 2021.
Article in English | MEDLINE | ID: covidwho-1443743

ABSTRACT

INTRODUCTION: Diabetes is the most common of comorbidity in patients with SARS-COV-2 pneumonia. Coagulation abnormalities with D-dimer levels are increased in this disease. OBJECTIFS: We aimed to compare the levels of D-dimer in diabetic and non-diabetic patients with COVID 19. A link between D-dimer and mortality has also been established. MATERIALS: A retrospective study was carried out at the University Hospital Center of Oujda (Morocco) from November 01st to December 01st, 2020. Our study population was divided into two groups: a diabetic group and a second group without diabetes to compare clinical and biological characteristics between the two groups. In addition, the receiver operator characteristic curve was used to assess the optimal D-dimer cut-off point for predicting mortality in diabetics. RESULTS: 201 confirmed-COVID-19-patients were included in the final analysis. The median age was 64 (IQR 56-73), and 56% were male. Our study found that D-dimer levels were statistically higher in diabetic patients compared to non-diabetic patients. (1745 vs 845 respectively, P = 0001). D-dimer level > 2885 ng/mL was a significant predictor of mortality in diabetic patients with a sensitivity of 71,4% and a specificity of 70,7%. CONCLUSION: Our study found that diabetics with COVID-19 are likely to develop hypercoagulation with a poor prognosis.


Subject(s)
COVID-19/blood , Diabetes Mellitus/blood , Fibrin Fibrinogen Degradation Products/analysis , SARS-CoV-2 , Thrombophilia/blood , Aged , Area Under Curve , Biomarkers , C-Reactive Protein/analysis , COVID-19/complications , COVID-19/epidemiology , Comorbidity , Diabetes Complications/blood , Diabetes Complications/epidemiology , Diabetes Mellitus/epidemiology , Female , Hospital Mortality , Humans , Hypertension/epidemiology , Inflammation/immunology , Kaplan-Meier Estimate , Male , Middle Aged , Oxidative Stress , Prognosis , ROC Curve , Retrospective Studies , Risk Factors , Thrombophilia/etiology , Thrombophilia/immunology
3.
Eur J Endocrinol ; 185(2): 299-311, 2021 Jul 05.
Article in English | MEDLINE | ID: covidwho-1398974

ABSTRACT

Objective: Male sex is one of the determinants of severe coronavirus diseas-e-2019 (COVID-19). We aimed to characterize sex differences in severe outcomes in adults with diabetes hospitalized for COVID-19. Methods: We performed a sex-stratified analysis of clinical and biological features and outcomes (i.e. invasive mechanical ventilation (IMV), death, intensive care unit (ICU) admission and home discharge at day 7 (D7) or day 28 (D28)) in 2380 patients with diabetes hospitalized for COVID-19 and included in the nationwide CORONADO observational study (NCT04324736). Results: The study population was predominantly male (63.5%). After multiple adjustments, female sex was negatively associated with the primary outcome (IMV and/or death, OR: 0.66 (0.49-0.88)), death (OR: 0.49 (0.30-0.79)) and ICU admission (OR: 0.57 (0.43-0.77)) at D7 but only with ICU admission (OR: 0.58 (0.43-0.77)) at D28. Older age and a history of microvascular complications were predictors of death at D28 in both sexes, while chronic obstructive pulmonary disease (COPD) was predictive of death in women only. At admission, C-reactive protein (CRP), aspartate amino transferase (AST) and estimated glomerular filtration rate (eGFR), according to the CKD-EPI formula predicted death in both sexes. Lymphocytopenia was an independent predictor of death in women only, while thrombocytopenia and elevated plasma glucose concentration were predictors of death in men only. Conclusions: In patients with diabetes admitted for COVID-19, female sex was associated with lower incidence of early severe outcomes, but did not influence the overall in-hospital mortality, suggesting that diabetes mitigates the female protection from COVID-19 severity. Sex-associated biological determinants may be useful to optimize COVID-19 prevention and management in women and men.


Subject(s)
COVID-19/diagnosis , COVID-19/epidemiology , Diabetes Mellitus/diagnosis , Diabetes Mellitus/epidemiology , Sex Characteristics , Aged , Aged, 80 and over , COVID-19/complications , COVID-19/therapy , Diabetes Complications/diagnosis , Diabetes Complications/epidemiology , Female , France/epidemiology , Hospital Mortality , Hospitalization/statistics & numerical data , Humans , Incidence , Inpatients , Intensive Care Units/statistics & numerical data , Male , Middle Aged , Prognosis , Respiration, Artificial/statistics & numerical data , Retrospective Studies , Risk Factors , SARS-CoV-2/physiology , Severity of Illness Index
4.
Metabolism ; 123: 154845, 2021 10.
Article in English | MEDLINE | ID: covidwho-1340768

ABSTRACT

PURPOSE: Individuals with diabetes/stress hyperglycemia carry an increased risk for adverse clinical outcome in case of SARS-CoV-2 infection. The purpose of this study was to evaluate whether this risk is, at least in part, modulated by an increase of thromboembolic complications. METHODS: We prospectively followed 180 hospitalized patients with confirmed COVID-19 pneumonia admitted to the Internal Medicine Units of San Raffaele Hospital. Data from 11 out of 180 patients were considered incomplete and excluded from the analysis. We analysed inflammation, tissue damage biomarkers, hemostatic parameters, thrombotic events (TEs) and clinical outcome according to the presence of diabetes/stress hyperglycemia. RESULTS: Among 169 patients, 51 (30.2%) had diabetes/stress hyperglycemia. Diabetes/stress hyperglycemia and fasting blood glucose (FBG) were associated with increased inflammation and tissue damage circulating markers, higher D-dimer levels, increased prothrombin time and lower antithrombin III activity. Forty-eight venous and 10 arterial TEs were identified in 49 (29%) patients. Diabetes/stress hyperglycemia (HR 2.71, p = 0.001), fasting blood glucose (HR 4.32, p < 0.001) and glucose variability (HR 1.6, p < 0.009) were all associated with an increased risk of thromboembolic complication. TEs significantly increased the risk for an adverse clinical outcome only in the presence of diabetes/stress hyperglycemia (HR 3.05, p = 0.010) or fasting blood glucose ≥7 mmol/L (HR 3.07, p = 0.015). CONCLUSIONS: Thromboembolism risk is higher among patients with diabetes/stress hyperglycemia and COVID-19 pneumonia and is associated to poor clinical outcome. In case of SARS-Cov-2 infection patients with diabetes/stress hyperglycemia could be considered for a more intensive prophylactic anticoagulation regimen.


Subject(s)
COVID-19/epidemiology , Diabetes Mellitus/epidemiology , Hyperglycemia/epidemiology , Thromboembolism/etiology , Aged , Aged, 80 and over , COVID-19/complications , COVID-19/diagnosis , COVID-19/therapy , Diabetes Complications/diagnosis , Diabetes Complications/epidemiology , Diabetes Complications/therapy , Diabetes Mellitus/blood , Diabetes Mellitus/diagnosis , Diabetes Mellitus/therapy , Female , Follow-Up Studies , Hospitalization/statistics & numerical data , Humans , Hyperglycemia/diagnosis , Hyperglycemia/etiology , Hyperglycemia/therapy , Inflammation/complications , Inflammation/diagnosis , Inflammation/epidemiology , Inflammation/therapy , Italy/epidemiology , Male , Middle Aged , Mortality , Prognosis , Risk Factors , Stress, Psychological/complications , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , Thromboembolism/diagnosis , Thromboembolism/epidemiology , Treatment Outcome
5.
Diabetes Metab Syndr ; 15(5): 102231, 2021.
Article in English | MEDLINE | ID: covidwho-1333363

ABSTRACT

BACKGROUND AND AIM: This review aims to report the current status of COVID-19 among people with diabetes, newly diagnosed diabetes, diabetic ketoacidosis, and programmatic efforts including vaccinations. METHODS: We conducted a literature search using PubMed, Google, and Scopus until July 15, 2021. RESULTS: In Saudi Arabia, most studies have reported diabetes as one of the highly prevalent comorbidities among patients with COVID-19. Currently, there are limited studies from Saudi Arabia on the newly diagnosed diabetes and diabetic ketoacidosis caused by COVID-19. The Saudi ministry has taken several measures to control the impact of COVID-19 among people with diabetes, including comprehensive guidelines and prioritized vaccinations. During the COVID-19 pandemic, the use of telehealth services dramatically increased in diabetes clinics in Saudi Arabia. CONCLUSIONS: Focused and evidence-based interventions are essential to control the impact of COVID-19 among people with diabetes.


Subject(s)
COVID-19/epidemiology , Diabetes Complications/epidemiology , COVID-19/complications , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Diabetes Complications/complications , Diabetes Mellitus/epidemiology , Diabetic Ketoacidosis/complications , Diabetic Ketoacidosis/epidemiology , Humans , Pandemics , SARS-CoV-2/physiology , Saudi Arabia/epidemiology , Vaccination/statistics & numerical data
6.
Diabetes Metab Syndr ; 15(5): 102228, 2021.
Article in English | MEDLINE | ID: covidwho-1333362

ABSTRACT

AIM: Amidst COVID-19 pandemic, the health care delivery in India faces major challenges owing to the overwhelming hospitals, exhausted healthcare workers, and shortage of crucial medical supplies such as ventilators and oxygen. The study aims to propose a novel successful interventional home care model, the Virtual COVID In-Patient (VCIP) care for effective COVID management. METHODS: The Covid-19 positive patients enrolled in VCIP were chosen for the study. A 24/7 active multidisciplinary WhatsApp group was created for each patient, for remote monitoring of temperature, blood pressure, blood glucose, respiratory and pulse rate along with the symptoms. Advice on sleep and exercises were given along with the medication via video-audio consultations. Lab facility was provided at the doorstep. Training on various devices, medications including steroids, delivering subcutaneous injections etc were given via video platforms. RESULTS: Among the 220 patients who availed the VCIP facility, only two were hospitalized, yielding a 99.5 % success rate in preventing hospitalizations and patients enrolled have been immensely satisfied with their experience. CONCLUSIONS: With similar pandemics anticipated in near future, VCIP model may be considered for successful domiciliary treatment and overcoming the challenges.


Subject(s)
COVID-19/therapy , Home Care Services/organization & administration , Models, Organizational , Algorithms , COVID-19/complications , COVID-19/diagnosis , COVID-19/epidemiology , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Diabetes Complications/epidemiology , Diabetes Complications/therapy , Diabetes Mellitus/epidemiology , Diabetes Mellitus/therapy , Female , Hospitalization/statistics & numerical data , Humans , India/epidemiology , Internationality , Male , Middle Aged , Models, Nursing , Monitoring, Physiologic/methods , Pandemics , Prognosis , Referral and Consultation/organization & administration , Telemedicine/organization & administration , Treatment Outcome
7.
J Med Virol ; 93(12): 6660-6670, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1330342

ABSTRACT

With the wide spread of Coronavirus, most people who infected with the COVID-19, will recover without requiring special treatment. Whereas, elders and those with underlying medical problems are more likely to have serious illnesses, even be threatened with death. Many more disciplines try to find solutions and drive master plan to this global trouble. Consequently, by taking one particular population, Hungary, this study aims to explore a pattern of COVID-19 victims, who suffered from some underlying conditions. Age, gender, and underlying medical problems form the structure of the clustering. K-Means and two step clustering methods were applied for age-based and age-independent analysis. Grouping of the deaths in the form of two different scenarios may highlight some concepts of this deadly disease for public health professionals. Our result for clustering can forecast similar cases which are assigned to any cluster that it will be a serious cautious for the population.


Subject(s)
COVID-19/epidemiology , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Asthma/complications , COVID-19/etiology , Diabetes Complications/epidemiology , Female , Humans , Hungary/epidemiology , Lung Diseases/complications , Male , Middle Aged , Neoplasms/complications , Obesity/complications , Risk Factors , Schizophrenia/complications , Sex Factors , Young Adult
8.
Prev Chronic Dis ; 18: E66, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1323410

ABSTRACT

INTRODUCTION: Severe COVID-19 illness in adults has been linked to underlying medical conditions. This study identified frequent underlying conditions and their attributable risk of severe COVID-19 illness. METHODS: We used data from more than 800 US hospitals in the Premier Healthcare Database Special COVID-19 Release (PHD-SR) to describe hospitalized patients aged 18 years or older with COVID-19 from March 2020 through March 2021. We used multivariable generalized linear models to estimate adjusted risk of intensive care unit admission, invasive mechanical ventilation, and death associated with frequent conditions and total number of conditions. RESULTS: Among 4,899,447 hospitalized adults in PHD-SR, 540,667 (11.0%) were patients with COVID-19, of whom 94.9% had at least 1 underlying medical condition. Essential hypertension (50.4%), disorders of lipid metabolism (49.4%), and obesity (33.0%) were the most common. The strongest risk factors for death were obesity (adjusted risk ratio [aRR] = 1.30; 95% CI, 1.27-1.33), anxiety and fear-related disorders (aRR = 1.28; 95% CI, 1.25-1.31), and diabetes with complication (aRR = 1.26; 95% CI, 1.24-1.28), as well as the total number of conditions, with aRRs of death ranging from 1.53 (95% CI, 1.41-1.67) for patients with 1 condition to 3.82 (95% CI, 3.45-4.23) for patients with more than 10 conditions (compared with patients with no conditions). CONCLUSION: Certain underlying conditions and the number of conditions were associated with severe COVID-19 illness. Hypertension and disorders of lipid metabolism were the most frequent, whereas obesity, diabetes with complication, and anxiety disorders were the strongest risk factors for severe COVID-19 illness. Careful evaluation and management of underlying conditions among patients with COVID-19 can help stratify risk for severe illness.


Subject(s)
COVID-19 , Diabetes Complications , Hospitalization/statistics & numerical data , Multimorbidity , Noncommunicable Diseases/epidemiology , Obesity , Phobic Disorders , Age Factors , Aged , COVID-19/mortality , COVID-19/therapy , Comorbidity , Diabetes Complications/diagnosis , Diabetes Complications/epidemiology , Female , Humans , Male , Mortality , Obesity/diagnosis , Obesity/epidemiology , Phobic Disorders/diagnosis , Phobic Disorders/epidemiology , Risk Assessment/methods , Risk Assessment/statistics & numerical data , Risk Factors , SARS-CoV-2 , Severity of Illness Index , United States/epidemiology
9.
Front Endocrinol (Lausanne) ; 12: 649525, 2021.
Article in English | MEDLINE | ID: covidwho-1295632

ABSTRACT

The relationship between COVID-19 and diabetes mellitus is complicated and bidirectional. On the one hand, diabetes mellitus is considered one of the most important risk factors for a severe course of COVID-19. Several factors that are often present in diabetes mellitus are likely to contribute to this risk, such as older age, a proinflammatory and hypercoagulable state, hyperglycemia and underlying comorbidities (hypertension, cardiovascular disease, chronic kidney disease and obesity). On the other hand, a severe COVID-19 infection, and its treatment with steroids, can have a specific negative impact on diabetes itself, leading to worsening of hyperglycemia through increased insulin resistance and reduced ß-cell secretory function. Worsening hyperglycemia can, in turn, adversely affect the course of COVID-19. Although more knowledge gradually surfaces as the pandemic progresses, challenges in understanding the interrelationship between COVID-19 and diabetes remain.


Subject(s)
COVID-19/etiology , COVID-19/pathology , Diabetes Mellitus , COVID-19/diagnosis , COVID-19/epidemiology , Diabetes Complications/diagnosis , Diabetes Complications/epidemiology , Diabetes Complications/pathology , Diabetes Mellitus/diagnosis , Diabetes Mellitus/epidemiology , Diabetes Mellitus/pathology , Diabetes Mellitus/virology , Disease Progression , Humans , Pandemics , Prognosis , Risk Factors , SARS-CoV-2/physiology , Severity of Illness Index
10.
Prev Chronic Dis ; 18: E66, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1290851

ABSTRACT

INTRODUCTION: Severe COVID-19 illness in adults has been linked to underlying medical conditions. This study identified frequent underlying conditions and their attributable risk of severe COVID-19 illness. METHODS: We used data from more than 800 US hospitals in the Premier Healthcare Database Special COVID-19 Release (PHD-SR) to describe hospitalized patients aged 18 years or older with COVID-19 from March 2020 through March 2021. We used multivariable generalized linear models to estimate adjusted risk of intensive care unit admission, invasive mechanical ventilation, and death associated with frequent conditions and total number of conditions. RESULTS: Among 4,899,447 hospitalized adults in PHD-SR, 540,667 (11.0%) were patients with COVID-19, of whom 94.9% had at least 1 underlying medical condition. Essential hypertension (50.4%), disorders of lipid metabolism (49.4%), and obesity (33.0%) were the most common. The strongest risk factors for death were obesity (adjusted risk ratio [aRR] = 1.30; 95% CI, 1.27-1.33), anxiety and fear-related disorders (aRR = 1.28; 95% CI, 1.25-1.31), and diabetes with complication (aRR = 1.26; 95% CI, 1.24-1.28), as well as the total number of conditions, with aRRs of death ranging from 1.53 (95% CI, 1.41-1.67) for patients with 1 condition to 3.82 (95% CI, 3.45-4.23) for patients with more than 10 conditions (compared with patients with no conditions). CONCLUSION: Certain underlying conditions and the number of conditions were associated with severe COVID-19 illness. Hypertension and disorders of lipid metabolism were the most frequent, whereas obesity, diabetes with complication, and anxiety disorders were the strongest risk factors for severe COVID-19 illness. Careful evaluation and management of underlying conditions among patients with COVID-19 can help stratify risk for severe illness.


Subject(s)
COVID-19 , Diabetes Complications , Hospitalization/statistics & numerical data , Multimorbidity , Noncommunicable Diseases/epidemiology , Obesity , Phobic Disorders , Age Factors , Aged , COVID-19/mortality , COVID-19/therapy , Comorbidity , Diabetes Complications/diagnosis , Diabetes Complications/epidemiology , Female , Humans , Male , Mortality , Obesity/diagnosis , Obesity/epidemiology , Phobic Disorders/diagnosis , Phobic Disorders/epidemiology , Risk Assessment/methods , Risk Assessment/statistics & numerical data , Risk Factors , SARS-CoV-2 , Severity of Illness Index , United States/epidemiology
11.
Diabetes Metab Syndr ; 15(3): 757-764, 2021.
Article in English | MEDLINE | ID: covidwho-1269263

ABSTRACT

BACKGROUND AND AIMS: COVID-19 is a pandemic that has affected beyond 100 million and caused nearly 3 million deaths globally. Vitamin D is a known risk factor for COVID-19. Therefore, we aimed to investigate the association of prevalence of vitamin D deficiency and mean vitamin D level with COVID-19 infection and mortality in Asia, predicting with other confounding factors such as median age, obesity, and diabetes. METHODS: COVID-19 infections and mortalities among the Asian countries were retrieved from the Worldometer website. Information on prevalence of vitamin D deficiency and mean vitamin D values in each Asian country was retrieved through literature searching on PubMed® and Google scholar. The associations between COVID-19 infections and mortalities with prevalence of vitamin D deficiency and mean vitamin D level were explored with correlation coefficients. As a predictive analysis, multiple linear regression was carried out with all confounders. RESULTS: Positive correlations were observed for prevalence of vitamin D deficiency with COVID-19 infections (r = 0.55; p = 0.01; R2 = 0.31) and mortalities (r = 0.50; p = 0.01; R2 = 0.25). Moreover, the associations for the COVID-19 infections and mortalities improved to r = 0.76 (p = 0.002; R2 = 0.58) and r = 0.65 (p = 0.03; R2 = 0.42), respectively, after predicting with confounding factors. Similarly, mean vitamin D level had a significant negative correlation with COVID-19 infections (r = -0.77; p = 0.04; R2 = 0.59) and mortalities (r = -0.80; p = 0.03; R2 = 0.63) when combining with confounders. CONCLUSION: Prevalence of vitamin D deficiency is significantly positively associated whereas the mean vitamin D level is significantly negatively associated with both infection and mortality rate of COVID-19 among Asian countries upon predicting with all confounders.


Subject(s)
COVID-19/epidemiology , Vitamin D Deficiency/epidemiology , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Asia/epidemiology , COVID-19/blood , COVID-19/mortality , Child , Child, Preschool , Diabetes Complications/epidemiology , Diabetes Mellitus/epidemiology , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Mortality , Obesity/complications , Obesity/epidemiology , Pandemics , Prevalence , Risk Factors , SARS-CoV-2/physiology , Vitamin D Deficiency/mortality , Young Adult
12.
Virol J ; 18(1): 126, 2021 06 12.
Article in English | MEDLINE | ID: covidwho-1266497

ABSTRACT

BACKGROUND: Tens of million cases of coronavirus disease-2019 (COVID-19) have occurred globally. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) attacks the respiratory system, causing pneumonia and lymphopenia in infected individuals. The aim of the present study is to investigate the laboratory characteristics of the viral load, lymphocyte subset and cytokines in asymptomatic individuals with SARS-CoV-2 infection in comparison with those in symptomatic patients with COVID-19. METHODS: From January 24, 2020, to April 11, 2020, 48 consecutive subjects were enrolled in this study. Viral loads were detected by RT-PCR from throat-swab, sputum and feces samples. Lymphocyte subset levels of CD3 + , CD4 + , and CD8 + T lymphocytes, B cells and NK cells were determined with biological microscope and flow cytometric analysis. Plasma cytokines (IL2, IL4, IL5, IL6, IL8, IL10, TNF-α, IFN-α and IFN-γ) were detected using flow cytometer. Analysis of variance (ANOVA), Chi-square or Fisher's exact test and Pearson's Correlation assay was used for all data. RESULTS: Asymptomatic (AS), mild symptoms (MS) and severe or critical cases (SCS) with COVID-19 were 11 (11/48, 22.9%), 26 (54.2%, 26/48) and 11 cases (11/48, 22.9%), respectively. The mean age of AS group (47.3 years) was lower than SCS group (63.5 years) (P < 0.05). Diabetes mellitus in AS, MS and SCS patients with COVID-19 were 0, 6 and 5 cases, respectively, and there was a significant difference between AS and SCS (P < 0.05). No statistical differences were found in the viral loads of SARS-CoV-2 between AS, MS and SCS groups on admission to hospital and during hospitalization. The concentration of CD 3 + T cells (P < 0.05), CD3 + CD4 + T cells (P < 0.05), CD3 + CD8 + T cells (P < 0.01), and B cells (P < 0.05) in SCS patients was lower than in AS and MS patients, while the level of IL-5 (P < 0.05), IL-6 (P < 0.05), IL-8 (P < 0.01) and IL-10 (P < 0.01), and TNF-α (P < 0.05) was higher. The age was negatively correlated with CD3 + T cells (P < 0.05), CD3 + CD4 + T cells (P < 0.05), and positively correlated with IL-2 (P < 0.001), IL-5 (P < 0.05), IL-6 (P < 0.05) IL-8 (P < 0.05), and IL-10 (P < 0.05). The viral loads were positively correlated with IL-2 (P < 0.001), IL-5 (P < 0.05), IL-6 (P < 0.05) IL-8 (P < 0.05) and IL-10 (P < 0.05), while negatively correlated with CD 3 + T cells (P < 0.05) and CD3 + CD4 + T cells (P < 0.05). CONCLUSIONS: The viral loads are similar between asymptomatic, mild and severe or critical patients with COVID-19. The severity of COVID-19 may be related to underlying diseases such as diabetes mellitus. Lymphocyte subset and plasma cytokine levels may be as the markers to distinguish severely degrees of disease, and asymptomatic patients may be as an important source of infection for the COVID-19.


Subject(s)
COVID-19/pathology , Cytokines/blood , Lymphocyte Subsets/pathology , SARS-CoV-2 , Viral Load , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Asymptomatic Infections , COVID-19/epidemiology , COVID-19/immunology , COVID-19/virology , Critical Illness , Diabetes Complications/epidemiology , Female , Hospitalization , Humans , Male , Middle Aged , Retrospective Studies , SARS-CoV-2/pathogenicity , Young Adult
14.
J Clin Endocrinol Metab ; 106(10): e4007-e4016, 2021 09 27.
Article in English | MEDLINE | ID: covidwho-1261287

ABSTRACT

CONTEXT: The coronavirus disease 2019 (COVID-19) pandemic has created a need for remote blood glucose (BG) monitoring in the intensive care unit (ICU). OBJECTIVE: To evaluate feasibility and patient safety of a hybrid monitoring strategy of point-of-care (POC) BG plus continuous glucose monitor (CGM) in the ICU. DESIGN: Retrospective analysis. SETTING: ICU of an academic medical center. PATIENTS: Patients with COVID-19 on IV insulin. INTERVENTION: After meeting initial validation criteria, CGM was used for IV insulin titration and POC BG was performed every 6 hours or as needed. MAIN OUTCOME MEASURES: Outcomes included frequency of POC BG, workflow, safety, and accuracy measures. RESULTS: The study included 19 patients, 18 with CGM data, mean age 58 years, 89% on mechanical ventilation, 37% on vasopressors, and 42% on dialysis. The median time to CGM validation was 137 minutes (interquartile range [IQR] 114-206). During IV insulin, the median number of POC values was 7 (IQR 6-16) on day 1, and declined slightly thereafter (71% reduction compared with standard of 24/day). The median number of CGM values used nonadjunctively to titrate IV insulin was 11.5 (IQR 0, 15) on day 1 and increased thereafter. Time in range 70 to 180 mg/dL was 64 ± 23% on day 1 and 72 ± 16% on days 2 through 7, whereas time <70 mg/dL was 1.5 ± 4.1% on day 1 and <1% on days 2 through 7. CONCLUSIONS: This study provides data to support that CGM using a hybrid protocol is feasible, accurate, safe, and has potential to reduce nursing and staff workload.


Subject(s)
Blood Glucose Self-Monitoring/methods , COVID-19/epidemiology , Diabetes Mellitus/epidemiology , Diabetes Mellitus/therapy , Insulin/administration & dosage , SARS-CoV-2 , Adult , Aged , Blood Glucose/analysis , COVID-19/therapy , Comorbidity , Critical Illness/therapy , Diabetes Complications/epidemiology , Diabetes Complications/therapy , Diabetes Complications/virology , Female , Glycemic Control/methods , Humans , Infusions, Intravenous , Intensive Care Units , Male , Middle Aged , Point-of-Care Systems , Retrospective Studies , Treatment Outcome
15.
Eur J Endocrinol ; 185(2): 299-311, 2021 Jul 05.
Article in English | MEDLINE | ID: covidwho-1259263

ABSTRACT

Objective: Male sex is one of the determinants of severe coronavirus diseas-e-2019 (COVID-19). We aimed to characterize sex differences in severe outcomes in adults with diabetes hospitalized for COVID-19. Methods: We performed a sex-stratified analysis of clinical and biological features and outcomes (i.e. invasive mechanical ventilation (IMV), death, intensive care unit (ICU) admission and home discharge at day 7 (D7) or day 28 (D28)) in 2380 patients with diabetes hospitalized for COVID-19 and included in the nationwide CORONADO observational study (NCT04324736). Results: The study population was predominantly male (63.5%). After multiple adjustments, female sex was negatively associated with the primary outcome (IMV and/or death, OR: 0.66 (0.49-0.88)), death (OR: 0.49 (0.30-0.79)) and ICU admission (OR: 0.57 (0.43-0.77)) at D7 but only with ICU admission (OR: 0.58 (0.43-0.77)) at D28. Older age and a history of microvascular complications were predictors of death at D28 in both sexes, while chronic obstructive pulmonary disease (COPD) was predictive of death in women only. At admission, C-reactive protein (CRP), aspartate amino transferase (AST) and estimated glomerular filtration rate (eGFR), according to the CKD-EPI formula predicted death in both sexes. Lymphocytopenia was an independent predictor of death in women only, while thrombocytopenia and elevated plasma glucose concentration were predictors of death in men only. Conclusions: In patients with diabetes admitted for COVID-19, female sex was associated with lower incidence of early severe outcomes, but did not influence the overall in-hospital mortality, suggesting that diabetes mitigates the female protection from COVID-19 severity. Sex-associated biological determinants may be useful to optimize COVID-19 prevention and management in women and men.


Subject(s)
COVID-19/diagnosis , COVID-19/epidemiology , Diabetes Mellitus/diagnosis , Diabetes Mellitus/epidemiology , Sex Characteristics , Aged , Aged, 80 and over , COVID-19/complications , COVID-19/therapy , Diabetes Complications/diagnosis , Diabetes Complications/epidemiology , Female , France/epidemiology , Hospital Mortality , Hospitalization/statistics & numerical data , Humans , Incidence , Inpatients , Intensive Care Units/statistics & numerical data , Male , Middle Aged , Prognosis , Respiration, Artificial/statistics & numerical data , Retrospective Studies , Risk Factors , SARS-CoV-2/physiology , Severity of Illness Index
17.
Diabetes Metab Syndr ; 15(3): 1009-1016, 2021.
Article in English | MEDLINE | ID: covidwho-1228013

ABSTRACT

BACKGROUND: Patients with coronavirus disease-2019 (COVID-19) with preexisting diabetes and cardiovascular metabolic diseases have higher fatality rate. The circulation of new variants with emerging clinical characteristics requires more studies focusing the impact of preexisting health conditions on outcome of COVID-19 accurately. AIMS: Main aim of this study was to investigate the impact of diabetes and cardiovascular disease (CVD) on disease prognosis and severe health outcomes among patients with COVID-19. METHODS: A retrospective study was performed on 799 patients with COVID-19 during December 10, 2020, to February 10, 2020 in Bangladesh. Logistic regression analysis was performed for age, sex, diabetes, CVD and symptoms on fatality. Kaplan-Meier survival analysis was conducted to predict the survival rate. RESULTS: Fatality was detected in 40% (318 of 799) patients with COVID-19. Among 318 fatalities, 90.6% were detected in patients with CVD and 74.5% in patients with diabetes. Case fatality rate was highest in patients with COVID-19, CVD and diabetes (94, 184 of 195). Fever (91%) and dry cough (71%) were the most frequent symptoms. CVD (42.2%), diabetes (32.7%) and obesity (18%) were prevalent. The highest odds of risk was detected in patients with COVID-19, CVD and diabetes (OR: 6.98, 95% CI, 4.21 to 7.34). Female patients had the highest survival rate. CONCLUSIONS: In this study, 318 fatality was seen in 799 patients with COVID-19. The highest odds of fatality risk was detected in patients with COVID-19, CVD and diabetes. The risk increased many folds when CVD and diabetes coexisted in patients.


Subject(s)
COVID-19/diagnosis , COVID-19/epidemiology , Cardiovascular Diseases/epidemiology , Diabetes Mellitus/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Bangladesh/epidemiology , COVID-19/complications , Cardiovascular Diseases/complications , Cardiovascular Diseases/diagnosis , Child , Child, Preschool , Comorbidity , Diabetes Complications/diagnosis , Diabetes Complications/epidemiology , Diabetes Mellitus/diagnosis , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Mortality , Prevalence , Prognosis , Retrospective Studies , SARS-CoV-2/physiology , Socioeconomic Factors , Young Adult
18.
Horm Metab Res ; 53(5): 301-310, 2021 May.
Article in English | MEDLINE | ID: covidwho-1219992

ABSTRACT

This study examined the associations between diabetes and self-reported/familial COVID-19 infection and investigated health-related outcomes among those with diabetes during China's nationwide quarantine. The 2020 China COVID-19 Survey was administered anonymously via social media (WeChat). It was completed by 10 545 adults in all of mainland China's 31 provinces. The survey consisted of 74 items covering sociodemographic characteristics, preventive measures for COVID-19, lifestyle behaviors, and health-related outcomes during the period of quarantine. Regression models examined associations among study variables. Diabetes was associated with a six-fold increased risk of reporting COVID-19 infection among respondents or their family members. Among people with diabetes, individuals who rarely wore masks had double the risk of suspected COVID-19 infection compared with those who always wore masks, with an inverse J-shaped relationship between face mask wearing and suspected COVID-19 infection. People with diabetes tended to have both poor knowledge of COVID-19 and poor compliance with preventive measures, despite perceiving a high risk of personal infection (40.0% among respondents reporting diabetes and 8.0% without diabetes). Only 54-55% of these respondents claimed to consistently practice preventive measures, including wearing face masks. Almost 60% of those with diabetes experienced food or medication shortages during the quarantine period, which was much higher than those without diabetes. Importantly, respondents who experienced medication shortages reported a 63% higher COVID-19 infection rate. Diabetes was associated with an increased risk of self-reported personal and family member COVID-19 infection, which is mitigated by consistent use of face masks.


Subject(s)
COVID-19/complications , Diabetes Complications/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Anxiety/etiology , Anxiety/psychology , COVID-19/epidemiology , COVID-19/prevention & control , China/epidemiology , Cross-Sectional Studies , Diabetes Complications/prevention & control , Female , Health Knowledge, Attitudes, Practice , Humans , Life Style , Male , Masks , Middle Aged , Patient Compliance , Personal Protective Equipment , Pharmaceutical Preparations/supply & distribution , Quarantine , Socioeconomic Factors , Surveys and Questionnaires , Treatment Outcome , Young Adult
19.
Front Endocrinol (Lausanne) ; 12: 609470, 2021.
Article in English | MEDLINE | ID: covidwho-1191680

ABSTRACT

The pandemic of coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has involved more than one hundred million individuals, including more than two million deaths. Diabetes represents one of the most prevalent chronic conditions worldwide and significantly increases the risk of hospitalization and death in COVID-19 patients. In this review, we discuss the prevalence, the pathophysiological mechanisms, and the outcomes of COVID-19 infection in people with diabetes. We propose a rationale for using drugs prescribed in patients with diabetes and some pragmatic clinical recommendations to deal with COVID-19 in this kind of patient.


Subject(s)
COVID-19/complications , COVID-19/therapy , Diabetes Complications/therapy , Diabetes Mellitus, Type 2/therapy , COVID-19/epidemiology , Diabetes Complications/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/physiopathology , Disease Management , Humans , Pandemics , Prevalence
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