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1.
Front Public Health ; 10: 1050673, 2022.
Article in English | MEDLINE | ID: covidwho-2242873

ABSTRACT

Background: After the initial outbreak in China (December 2019), the World Health Organization declared COVID-19 a pandemic on March 11th, 2020. This paper aims to describe the first 2 years of the pandemic in Mexico. Design and methods: This is a population-based longitudinal study. We analyzed data from the national COVID-19 registry to describe the evolution of the pandemic in terms of the number of confirmed cases, hospitalizations, deaths and reported symptoms in relation to health policies and circulating variants. We also carried out logistic regression to investigate the major risk factors for disease severity. Results: From March 2020 to March 2022, the coronavirus disease 2019 (COVID-19) pandemic in Mexico underwent four epidemic waves. Out of 5,702,143 confirmed cases, 680,063 were hospitalized (11.9%), and 324,436 (5.7%) died. Even if there was no difference in susceptibility by gender, males had a higher risk of death (CFP: 7.3 vs. 4.2%) and hospital admission risk (HP: 14.4 vs. 9.5%). Severity increased with age. With respect to younger ages (0-17 years), the 60+ years or older group reached adjusted odds ratios of 9.63 in the case of admission and 53.05 (95% CI: 27.94-118.62) in the case of death. The presence of any comorbidity more than doubled the odds ratio, with hypertension-diabetes as the riskiest combination. While the wave peaks increased over time, the odds ratios for developing severe disease (waves 2, 3, and 4 to wave 1) decreased to 0.15 (95% CI: 0.12-0.18) in the fourth wave. Conclusion: The health policy promoted by the Mexican government decreased hospitalizations and deaths, particularly among older adults with the highest risk of admission and death. Comorbidities augment the risk of developing severe illness, which is shown to rise by double in the Mexican population, particularly for those reported with hypertension-diabetes. Factors such as the decrease in the severity of the SARS-CoV2 variants, changes in symptomatology, and advances in the management of patients, vaccination, and treatments influenced the decrease in mortality and hospitalizations.


Subject(s)
COVID-19 , Diabetes Mellitus , Hypertension , Male , Humans , Aged , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , COVID-19/epidemiology , SARS-CoV-2 , Pandemics , Longitudinal Studies , Mexico/epidemiology , Follow-Up Studies , RNA, Viral , Diabetes Mellitus/epidemiology , Hypertension/epidemiology
2.
JAMA Netw Open ; 6(2): e2255965, 2023 02 01.
Article in English | MEDLINE | ID: covidwho-2242423

ABSTRACT

This cohort study compares the risk of new-onset hypertension, hyperlipidemia, and diabetes before and after COVID-19 infection among patients who were vaccinated vs unvaccinated before infection.


Subject(s)
COVID-19 Vaccines , COVID-19 , Diabetes Mellitus , Humans , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Diabetes Mellitus/epidemiology , Vaccination
3.
Prim Care Diabetes ; 17(2): 141-147, 2023 Apr.
Article in English | MEDLINE | ID: covidwho-2245978

ABSTRACT

AIMS: Covid-19 caused changes on the delivery of diabetes care. This study aimed to explore perceptions of healthcare providers across Europe concerning 1) the impact of covid-19 on delivery of diabetes care; 2) impact of changes in diabetes care on experienced workload; 3) experiences with video consultation in diabetes care. METHODS: Cross-sectional survey among healthcare providers in the Netherlands, United Kingdom, Turkey, Ukraine and Sweden, with a focus on primary care. RESULTS: The survey was completed by 180 healthcare providers. During the COVID-19 pandemic 57.1% of respondents provided less diabetes care and 72.8% observed a negative impact on people with diabetes. More than half of respondents (61.9%) expressed worries to some extent about getting overloaded by work. Although the vast majority considered their work meaningful (85.6%). Almost half of healthcare providers (49.4%) thought that after the pandemic video-consultation could be blended with face-to-face contact. CONCLUSIONS: Less diabetes care was delivered and a negative impact on people with diabetes was observed by healthcare providers. Despite healthcare providers' feeling overloaded, mental wellbeing seemed unaffected. Video consultations were seen as having potential. Given the remaining covid-19 risks and from the interest of proactive management of people with diabetes, these findings urge for further exploration of incorporating video consultation in diabetes care.


Subject(s)
COVID-19 , Diabetes Mellitus , Humans , COVID-19/epidemiology , Pandemics , Cross-Sectional Studies , Health Personnel , Europe/epidemiology , Diabetes Mellitus/diagnosis , Diabetes Mellitus/epidemiology , Diabetes Mellitus/therapy
4.
Front Public Health ; 10: 1027312, 2022.
Article in English | MEDLINE | ID: covidwho-2245265

ABSTRACT

Background: The emergence of coronavirus disease (COVID-19) as a global pandemic has resulted in the loss of many lives and a significant decline in global economic losses. Thus, for a large country like India, there is a need to comprehend the dynamics of COVID-19 in a clustered way. Objective: To evaluate the clinical characteristics of patients with COVID-19 according to age, gender, and preexisting comorbidity. Patients with COVID-19 were categorized according to comorbidity, and the data over a 2-year period (1 January 2020 to 31 January 2022) were considered to analyze the impact of comorbidity on severe COVID-19 outcomes. Methods: For different age/gender groups, the distribution of COVID-19 positive, hospitalized, and mortality cases was estimated. The impact of comorbidity was assessed by computing incidence rate (IR), odds ratio (OR), and proportion analysis. Results: The results indicated that COVID-19 caused an exponential growth in mortality. In patients over the age of 50, the mortality rate was found to be very high, ~80%. Moreover, based on the estimation of OR, it can be inferred that age and various preexisting comorbidities were found to be predictors of severe COVID-19 outcomes. The strongest risk factors for COVID-19 mortality were preexisting comorbidities like diabetes (OR: 2.39; 95% confidence interval (CI): 2.31-2.47; p < 0.0001), hypertension (OR: 2.31; 95% CI: 2.23-2.39; p < 0.0001), and heart disease (OR: 2.19; 95% CI: 2.08-2.30; p < 0.0001). The proportion of fatal cases among patients positive for COVID-19 increased with the number of comorbidities. Conclusion: This study concluded that elderly patients with preexisting comorbidities were at an increased risk of COVID-19 mortality. Patients in the elderly age group with underlying medical conditions are recommended for preventive medical care or medical resources and vaccination against COVID-19.


Subject(s)
COVID-19 , Diabetes Mellitus , Humans , Aged , COVID-19/epidemiology , SARS-CoV-2 , Comorbidity , Diabetes Mellitus/epidemiology , Risk Factors
5.
Front Endocrinol (Lausanne) ; 14: 1136997, 2023.
Article in English | MEDLINE | ID: covidwho-2227312
6.
Front Endocrinol (Lausanne) ; 14: 1077959, 2023.
Article in English | MEDLINE | ID: covidwho-2231802

ABSTRACT

Purpose: The effect of renin-angiotensin-aldosterone system (RAAS) inhibitors in combination with COVID-19 and diabetes mellitus (DM) remains unknown. We assessed the risk of death in COVID-19 inpatients based on the presence or absence of DM, arterial hypertension (AH) and the use of RAAS inhibitors or other antihypertensives. Methods: The results of treatment of all adult PCR-confirmed COVID-19 inpatients (n = 1097, women 63.9%) from 02/12/2020 to 07/01/2022 are presented. The presence of DM at the time of admission and the category of antihypertensive drugs during hospital stay were noted. Leaving the hospital due to recovery or death was considered as a treatment outcome. Multivariable logistic regression analysis was used to assess the risk of death. Patients with COVID-19 without AH were considered the reference group. Results: DM was known in 150 of 1,097 patients with COVID-19 (13.7%). Mortality among DM inpatients was higher: 20.0% vs. 12.4% respectively (p=0.014). Male gender, age, fasting plasma glucose (FPG) and antihypertensives were independently associated with the risk of dying in patients without DM. In DM group such independent association was confirmed for FPG and treatment of AH. We found a reduction in the risk of death for COVID-19 inpatients without DM, who received RAAS inhibitors compared with the corresponding risk of normotensive inpatients, who did not receive antihypertensives: OR 0.22 (95% CI 0.07-0.72) adjusted for age, gender and FPG. Conclusion: This result raises a question about the study of RAAS inhibitors effect in patients with Covid-19 without AH.


Subject(s)
COVID-19 , Diabetes Mellitus , Hypertension , Adult , Humans , Male , Female , Antihypertensive Agents/therapeutic use , Antihypertensive Agents/pharmacology , Renin-Angiotensin System , COVID-19/complications , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/pharmacology , Inpatients , Angiotensin Receptor Antagonists/therapeutic use , Angiotensin Receptor Antagonists/pharmacology , Hypertension/complications , Hypertension/drug therapy , Hypertension/diagnosis , Diabetes Mellitus/drug therapy , Diabetes Mellitus/epidemiology , Diabetes Mellitus/chemically induced , COVID-19 Testing
8.
Front Public Health ; 10: 1050673, 2022.
Article in English | MEDLINE | ID: covidwho-2224939

ABSTRACT

Background: After the initial outbreak in China (December 2019), the World Health Organization declared COVID-19 a pandemic on March 11th, 2020. This paper aims to describe the first 2 years of the pandemic in Mexico. Design and methods: This is a population-based longitudinal study. We analyzed data from the national COVID-19 registry to describe the evolution of the pandemic in terms of the number of confirmed cases, hospitalizations, deaths and reported symptoms in relation to health policies and circulating variants. We also carried out logistic regression to investigate the major risk factors for disease severity. Results: From March 2020 to March 2022, the coronavirus disease 2019 (COVID-19) pandemic in Mexico underwent four epidemic waves. Out of 5,702,143 confirmed cases, 680,063 were hospitalized (11.9%), and 324,436 (5.7%) died. Even if there was no difference in susceptibility by gender, males had a higher risk of death (CFP: 7.3 vs. 4.2%) and hospital admission risk (HP: 14.4 vs. 9.5%). Severity increased with age. With respect to younger ages (0-17 years), the 60+ years or older group reached adjusted odds ratios of 9.63 in the case of admission and 53.05 (95% CI: 27.94-118.62) in the case of death. The presence of any comorbidity more than doubled the odds ratio, with hypertension-diabetes as the riskiest combination. While the wave peaks increased over time, the odds ratios for developing severe disease (waves 2, 3, and 4 to wave 1) decreased to 0.15 (95% CI: 0.12-0.18) in the fourth wave. Conclusion: The health policy promoted by the Mexican government decreased hospitalizations and deaths, particularly among older adults with the highest risk of admission and death. Comorbidities augment the risk of developing severe illness, which is shown to rise by double in the Mexican population, particularly for those reported with hypertension-diabetes. Factors such as the decrease in the severity of the SARS-CoV2 variants, changes in symptomatology, and advances in the management of patients, vaccination, and treatments influenced the decrease in mortality and hospitalizations.


Subject(s)
COVID-19 , Diabetes Mellitus , Hypertension , Male , Humans , Aged , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , COVID-19/epidemiology , SARS-CoV-2 , Pandemics , Longitudinal Studies , Mexico/epidemiology , Follow-Up Studies , RNA, Viral , Diabetes Mellitus/epidemiology , Hypertension/epidemiology
9.
Front Endocrinol (Lausanne) ; 14: 1136997, 2023.
Article in English | MEDLINE | ID: covidwho-2224764
10.
Saudi Med J ; 44(1): 67-73, 2023 Jan.
Article in English | MEDLINE | ID: covidwho-2204150

ABSTRACT

OBJECTIVES: To describe the effect of diabetes mellitus (DM) on clinical outcomes of patients admitted with COVID-19 infection. METHODS: We carried out a single center, observational, retrospective study. We included adult patients with laboratory-confirmed diagnosis of COVID-19 admitted to a tertiary hospital in Jeddah, Saudi Arabia, from April 2020 to December 2020. Electronic medical records were reviewed for demographics, clinical status, hospital course, and outcome; and they were compared between the patients with or without DM. RESULTS: Out of 198 patients included in the study, 86 (43.4%) were diabetic and 112 (56.5%) were non-diabetic. Majority of the patients were males 139 (70.2%) with a mean age of 54.14±14.89 years. In-hospital mortality rate was higher in diabetic patients than in non-diabetic patients (40 vs. 32; p=0.011). The most common comorbidity was hypertension (n=95, 48%) followed by ischemic heart disease (n=35, 17.7%), chronic kidney disease (n=17, 9.6%), and bronchial asthma (n=10, 5.1%). CONCLUSION: The risk of SARS-CoV-2 infection is higher among diabetic patients; particularly, those with preexisting co-morbidities or geriatric patients. Diabetic patients are prone to a severe clinical course of COVID-19 and a significantly higher mortality rate.


Subject(s)
COVID-19 , Diabetes Mellitus , Adult , Aged , Female , Humans , Male , Middle Aged , Comorbidity , Diabetes Mellitus/epidemiology , Morbidity , Retrospective Studies , SARS-CoV-2
11.
J Opioid Manag ; 18(6): 523-528, 2022.
Article in English | MEDLINE | ID: covidwho-2202522

ABSTRACT

BACKGROUND: There are limited studies regarding the effects of COVID-19 in patients with a concurrent diagnosis of opioid use disorder (OUD). Due to the rapidly developing nature and consequences of this disease, it is important to identify patients at an increased risk for serious illness. The aim of this study was to identify whether COVID-19 patients with OUD are at an increased risk of hospitalization and other adverse outcomes. METHODS: This retrospective chart review compared clinical parameters from patients with positive COVID-19 status as identified by a positive SARS-CoV-2 PCR test and diagnosed OUD at the University of Utah Health. The primary outcome variables were hospitalization for COVID-19, length of hospital stay, and the presence of comorbidities in the OUD patient population. Descriptive statistics and prevalence ratios (PRs) were generated. Log binomial models generated PRs adjusted by age, sex, and race, and comorbidities of asthma, pneumonia, hypertension, cardiovascular disease, and diabetes. RESULTS: COVID-19 patients with OUD were significantly more likely than patients without OUD to have asthma (p < 0.01), diabetes (p < 0.01), hypertension (p < 0.01), cardiovascular disease (p < 0.01), and chronic pneumonia (p < 0.01), and to be hospitalized (27.9 percent vs 3.6 percent; p < 0.01), admitted to the intensive care unit (11.5 percent vs 1.5 percent; p < 0.01), and receive mechanical ventilation (30.5 percent vs 0.1 percent; p < 0.01). After adjusting for age, sex, race, asthma, pneumonia, cardiovascular disease, hypertension, and diabetes, patients with OUD continued to be at increased risk for inpatient hospitalization (aPR = 4.27, 95 percent confidence interval [CI] = 1.66-10.94). Patients with OUD also averaged longer stays in the hospital than those without OUD (9.53 days vs 0.70 days, p < 0.001). CONCLUSION: Patients with a diagnosis of OUD in the presence of COVID-19 are more likely to be hospitalized, have underlying health issues, and have longer hospital inpatient stays compared to patients without OUD.


Subject(s)
Asthma , COVID-19 , Cardiovascular Diseases , Diabetes Mellitus , Hypertension , Opioid-Related Disorders , Humans , SARS-CoV-2 , Retrospective Studies , Analgesics, Opioid/adverse effects , Opioid-Related Disorders/diagnosis , Opioid-Related Disorders/epidemiology , Opioid-Related Disorders/therapy , Hospitalization , Diabetes Mellitus/epidemiology , Hypertension/epidemiology
12.
BMC Public Health ; 23(1): 103, 2023 01 14.
Article in English | MEDLINE | ID: covidwho-2196202

ABSTRACT

BACKGROUND: Ensuring health equity, especially for vulnerable populations in less developed settings with poor health system is essential for the current and future global health threats. This study examined geographical variations of COVID-19 mortality and its association with population health characteristics, health care capacity in responding pandemic, and socio-economic characteristics across 514 districts in Indonesia. METHODS: This nationwide ecological study included aggregated data of COVID-19 cases and deaths from all 514 districts in Indonesia, recorded in the National COVID-19 Task Force database, during the first two years of the epidemic, from 1 March 2020 to 27 February 2022. The dependent variable was district-level COVID-19 mortality rate per 100,000 populations. The independent variables include district-level COVID-19 incidence rate, population health, health care capacity, and socio-demographics data from government official sources. We used multivariable ordinal logistic regression to examine factors associated with higher mortality rate. RESULTS: Of total 5,539,333 reported COVID-19 cases, 148,034 (2.7%) died, and 5,391,299 (97.4%) were recovered. The district-level mortality rate ranged from 0 to 284 deaths per 100,000 populations. The top five districts with the highest mortality rate were Balikpapan (284 deaths per 100,000 populations), Semarang (263), Madiun (254), Magelang (250), and Yogyakarta (247). A higher COVID-19 incidence (coefficient 1.64, 95% CI 1.22 to 1.75), a higher proportion of ≥ 60 years old population (coefficient 0.26, 95% CI 0.06 to 0.46), a higher prevalence of diabetes mellitus (coefficient 0.60, 95% CI 0.37 to 0.84), a lower prevalence of obesity (coefficient -0.32, 95% CI -0.56 to -0.08), a lower number of nurses per population (coefficient -0.27, 95% CI -0.50 to -0.04), a higher number of midwives per population (coefficient 0.32, 95% CI 0.13 to 0.50), and a higher expenditure (coefficient 0.34, 95% CI 0.10 to 0.57) was associated with a higher COVID-19 mortality rate. CONCLUSION: COVID-19 mortality rate in Indonesia was highly heterogeneous and associated with higher COVID-19 incidence, different prevalence of pre-existing comorbidity, healthcare capacity in responding the pandemic, and socio-economic characteristics. This study revealed the need of controlling both COVID-19 and those known comorbidities, health capacity strengthening, and better resource allocation to ensure optimal health outcomes for vulnerable population.


Subject(s)
COVID-19 , Diabetes Mellitus , Humans , Middle Aged , COVID-19/epidemiology , Indonesia/epidemiology , Diabetes Mellitus/epidemiology , Comorbidity , Pandemics
13.
J Ayub Med Coll Abbottabad ; 34(Suppl 1)(4): S1027-S1029, 2022.
Article in English | MEDLINE | ID: covidwho-2207201

ABSTRACT

Coronavirus disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a deadly pandemic overburdening healthcare system globally. While people of all ages were affected, the older population has faced disproportionately higher morbidity and mortality, likely due to altered immune responses and pre-existing comorbid conditions like cardiovascular disease, hypertension, diabetes mellitus, chronic pulmonary and kidney disease. Clinical manifestations in older patients may also be atypical with absence of fever, increased chances of acute confusion and longer recovery times. While other parameters of disease severity have been found, poor glycaemic control is another indicator of severity in COVID 19 infection. Moreover, older patients with diabetes mellitus are also at risk of hypoglycaemia which increases the risk of cardiovascular and cerebrovascular events, progression of dementia, falls, emergency department visits and hospitalization. Here we share a case of an older man with COVID-19 infection who presented primarily with recurrent hypoglycaemia and weakness. This case also highlights the social impact of an infection that has decimated support systems for vulnerable older adults.


Subject(s)
COVID-19 , Diabetes Mellitus , Hypoglycemia , Male , Humans , Aged , COVID-19/complications , SARS-CoV-2 , Diabetes Mellitus/epidemiology , Comorbidity , Hypoglycemia/etiology
14.
J Nepal Health Res Counc ; 20(2): 347-353, 2022 Nov 02.
Article in English | MEDLINE | ID: covidwho-2206051

ABSTRACT

BACKGROUND: Health seeking behaviour can influence outcomes in chronic diseases such as diabetes. As diabetes burden is higher in urban areas and under half receive adequate diabetes care and support in Nepal, this study aimed to assess factors influencing health behaviour among persons with diabetes attending urban health care settings. METHODS: A cross-sectional study was conducted at two private healthcare settings with a pretested semi-structured questionnaire to assess health behaviour in particular with gender and regular diabetes follow-up. Bivariate analysis alongwith univariate and multivariate logistic regression was used to assess factors that influence HSB (P<0.05). Adjusted odds were reported within 95% confidence intervals. RESULTS: Among 385 PWDs (42.3% women) with a median diabetes duration of 7 years (IQR: 3 to 14 years), three fourths (75.1%, 95% CL: 70.5 to 79.1%) reported regular follow-up for diabetes care. After adjusting for confounders, the odds of regular follow-up were higher for those with a family history of diabetes (AOR: 1.82, 95% CI: 1.11 to 3.00) and non-smokers (AOR: 2.08, 95% CI: 1.34 to 3.61). The odds of follow-up were lower among the elderly (? 60 years) (AOR: 0.59, 95% CI: 0.35 to 0.97) and those with a family income below 35,000 Nepali rupees (AOR:0.39, 95% CI: 0.23 to 0.67). CONCLUSIONS: A plurality of health seeking behaviours such as regular follow-up care, taking glucose lowering medications and diabetes information seeking was observed among persons with diabetes attending private urban heath care settings during the COVID-19 pandemic period. Older age, family history of diabetes, non-smoking status and low family income were found to influence regular follow-up. In particular, psychosocial mechanisms that influence behavior among persons who smoke may need exploration.


Subject(s)
COVID-19 , Diabetes Mellitus , Humans , Female , Aged , Male , Cross-Sectional Studies , Pandemics , Urban Health , Nepal/epidemiology , Diabetes Mellitus/epidemiology , Health Behavior , Patient Acceptance of Health Care
15.
Transplantation ; 106(12): 2426-2434, 2022 Dec 01.
Article in English | MEDLINE | ID: covidwho-2135883

ABSTRACT

BACKGROUND: Solid organ transplant recipients (SOTr) are at increased risk for severe disease from coronavirus disease 2019 (COVID-19) compared with non-SOTr. METHODS: We performed a retrospective cohort study between March 1, 2020, and March, 30, 2021, in an integrated healthcare system with 4.3 million members aged ≥18 y including 5126 SOTr. Comparisons in COVID-19 mortality, hospitalization, and incidence were made between SOTr and non-SOTr, and between different SOTr organs. Multivariate analysis was performed to identify risk factors for COVID-19 mortality and hospitalization. RESULTS: There were 600 SOTr (kidney, liver, heart, and lung) with COVID-19. Per person-year incidence of COVID-19 among SOTr was 10.0% versus 7.6% among non-SOTr (P < 0.0001). Compared with uninfected SOTr, infected SOTr were older (57.1 ± 14.0 versus 45.7 ± 17.9 y, P < 0.001), predominantly Hispanic/Latino (58.8% versus 38.6%, P < 0.0001), hypertensive (77.0% versus 23.8%; P < 0.0001), and diabetic (49.6% versus 13.0%; P = 0.0009). Compared with non-SOTr, infected SOTr had higher hospitalization (39.5% versus 6.0%; P < 0.0001), intensive care unit admission (29.1% versus 15.5%; P < 0.0001), and mortality (14.7% versus 1.8%; P < 0.0001) from COVID-19. Older age (hazard ratio [HR], 1.07; 95% confidence interval [CI], 1.05-1.10), male gender (HR, 1.79; 95% CI, 1.11-2.86), and higher body mass index (HR, 1.04; 95% CI, 1.00-1.09; P = 0.047) were associated with increased mortality from COVID-19, whereas race, diabetes, and number/type of immunosuppressive medications were not. Among the different SOTr, COVID-19 mortality risk was lowest in liver recipients (HR, 0.34; 95% CI, 0.16-0.73) and highest in lung recipients (HR, 1.74; 95% CI, 0.68-4.42). CONCLUSIONS: SOTr have higher rates of hospitalization and mortality from COVID-19 compared with the general population. Among the SOTr, the incidence and outcomes were distinct among different transplantation types.


Subject(s)
COVID-19 , Diabetes Mellitus , Organ Transplantation , Humans , Male , Incidence , COVID-19/epidemiology , Retrospective Studies , Organ Transplantation/adverse effects , Cohort Studies , Risk Factors , Diabetes Mellitus/epidemiology , Diabetes Mellitus/etiology
16.
Sci Rep ; 12(1): 20191, 2022 Nov 23.
Article in English | MEDLINE | ID: covidwho-2133616

ABSTRACT

Emerging evidence suggests that coronavirus disease-2019 (COVID-19) may lead to a wide range of post-acute sequelae outcomes, including new onset of diabetes. The aim of this meta-analysis was to estimate the incidence of newly diagnosed diabetes in survivors of COVID-19. We searched MEDLINE, Scopus, Cochrane Central Register of Controlled Trials and the World Health Organization Global Literature on Coronavirus Disease and clinical trial registries for studies reporting the association of COVID-19 and diabetes. Search dates were December 2019-October 16, 2022. Two investigators independently assessed studies for inclusion. Risk of bias was assessed using the Newcastle-Ottawa Scale. We estimated the effect of COVID-19 on incident diabetes by random-effects meta-analyses using the generic inverse variance method. We identified 8 eligible studies consisting of 4,270,747 COVID-19 patients and 43,203,759 controls. Median age was 43 years (interquartile range, IQR 35-49), and 50% were female. COVID-19 was associated with a 66% higher risk of incident diabetes (risk ratio, 1.66; 95% CI 1.38; 2.00). The risk was not modified by age, sex, or study quality. The median risk of bias assessment was 7. In this systematic review and meta-analysis, COVID-19 was associated with higher risk for developing new onset diabetes among survivors. Active monitoring of glucose dysregulation after recovery from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is warranted.


Subject(s)
COVID-19 , Diabetes Mellitus , Humans , Female , Adult , Male , COVID-19/complications , COVID-19/epidemiology , SARS-CoV-2 , Diabetes Mellitus/epidemiology , Incidence , MEDLINE
17.
Rev Inst Med Trop Sao Paulo ; 64: e74, 2022.
Article in English | MEDLINE | ID: covidwho-2119439

ABSTRACT

Given the magnitude of COVID-19 and the increase in hospitalization cases for severe acute respiratory syndrome (SARS), especially among patients with diabetes mellitus, it is essential to understand the epidemiological aspects inherent to the disease and the worsening of cases. Thus, this study aimed to analyze the survival of patients with diabetes mellitus hospitalized for SARS due to COVID-19 in different regions of Brazil. This is a longitudinal study, carried out based on data reported in the Influenza Epidemiological Surveillance Information System during the year 2020. The number of patients with diabetes mellitus among the hospitalized cases of SARS due to COVID-19 in the different regions of Brazil and the lethality rate among them were identified. A comparison of patient profiles of those who survived or did not survive and the Cox regression analysis were performed to evaluate the factors associated with shorter survival of patients. It was found that 51.4% of patients hospitalized with SARS due to COVID-19 had diabetes, and the case lethality rate among them was 45.0%. The Northeastern and Northern regions presented a higher proportion of patients with diabetes mellitus (56.5% and 54.3%, respectively) and a higher lethality rate (53.8% and 59.9%, respectively). The mean survival time of cases with diabetes mellitus hospitalized for SARS due to COVID-19 was estimated to be 35.7 days (0.5 days). A lower survival rate was observed among residents of the Northeastern and Northern regions with skin color reported as non-white, who required admission to Intensive Care Units and invasive mechanical ventilation, and presented respiratory symptoms such as dyspnea, respiratory distress and an oxygen saturation lower than 95%. It is concluded that diabetes mellitus was responsible for the high occurrence and lethality, mainly in the Northeastern and Northern regions, among non-white patients and those with greater clinical severity, which reinforces the importance of taking measures aimed at supporting this population.


Subject(s)
COVID-19 , Diabetes Mellitus , Humans , SARS-CoV-2 , Longitudinal Studies , Hospitalization , Diabetes Mellitus/epidemiology , Dyspnea
18.
Saudi Med J ; 43(11): 1254-1259, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2119309

ABSTRACT

OBJECTIVES: To evaluate the clinical and laboratory characteristics of COVID-19 patients admitted to Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey, and to determine the factors affecting mortality. METHODS: A total of 500 patients who were diagnosed with COVID-19 between 19th of March and 30th of September 2020 in Afyonkarahisar Health Sciences University, Faculty of Medicine, Pandemic Service, Afyonkarahisar, Turkey, were retrospectively investigated for this study. These individuals' prognoses, demographic, clinical, laboratory, and radiological information were examined and recorded retrospectively. Comparisons were carried out between the characteristics of patients with a prognosis of death and those who recovered. RESULTS: Of the 500 definite COVID-19 cases included in the study, 53.8% were male and the mean age was 57.6±15.1 (18-88 years). The most common comorbidities were hypertension and diabetes mellitus. A total of 45 (9%) patients developed mortality. Factors such as advanced age, male gender, shortness of breath, fever at admission, comorbid conditions such as hypertension, diabetes mellitus, cardiovascular diseases, lymphopenia, high C-reactive protein, high D-dimer, and high ferritin in the laboratory were found to be important risk factors for mortality. Treatments such as hydroxychloroquine, favipiravir, and lopinavir/ritonavir were not found to have lower mortality rates than one another. CONCLUSION: Considering these elements when assessing patients and adjusting the course of treatment according to the recommendations of the most recent guidelines may lower mortality.


Subject(s)
COVID-19 , Diabetes Mellitus , Hypertension , Humans , Male , Adult , Middle Aged , Aged , Female , Retrospective Studies , SARS-CoV-2 , Diabetes Mellitus/epidemiology
19.
Rev Gaucha Enferm ; 43: e20210202, 2022.
Article in English, Portuguese | MEDLINE | ID: covidwho-2119244

ABSTRACT

OBJECTIVE: To analyze the resilience of people with diabetes mellitus during the COVID-19 pandemic. METHOD: Cross-sectional study carried out with 235 people with diabetes using a form shared on social media with sociodemographic and clinical data and the Connor-Davidson resilience scale validated for the Brazilian context. Scale scores were compared with sociodemographic and clinical data using Student's t-test, analysis of variance and Mann-Whitney. RESULTS: The mean score on the resilience scale was 63.58+14.5. The highest resilience scores were evidenced in men, people with higher income, higher education, users of oral antidiabetics, who had healthy diet and who performed physical activity and follow-up with the health team. CONCLUSION: Mean resilience was lower than the score shown in the literature and groups with higher scores had better health behaviors.


Subject(s)
COVID-19 , Diabetes Mellitus , Resilience, Psychological , Male , Humans , COVID-19/epidemiology , Pandemics , Cross-Sectional Studies , Diabetes Mellitus/epidemiology
20.
J Diabetes Complications ; 36(11): 108336, 2022 11.
Article in English | MEDLINE | ID: covidwho-2117652

ABSTRACT

The raging COVID-19 pandemic is in its third year of global impact. The SARS CoV 2 virus has a high rate of spread, protean manifestations, and a high morbidity and mortality in individuals with predisposing risk factors. The pathophysiologic mechanisms involve a heightened systemic inflammatory state, cardiometabolic derangements, and varying degrees of glucose intolerance. The latter can be evident as significant hyperglycemia leading to new-onset diabetes or worsening of preexisting disease. Unfortunately, the clinical course beyond the acute phase of the illness may persist in the form of a variety of symptoms that together form the so-called "Long COVID" or "Post-COVID Syndrome". It is thought that a chronic, low-grade inflammatory and immunologic state persists during this phase, which may last for weeks or months. Although numerous insights have been gained into COVID-related hyperglycemia and diabetes, its prediction, course, and management remain to be fully elucidated.


Subject(s)
COVID-19 , Diabetes Mellitus , Hyperglycemia , Humans , SARS-CoV-2 , Pandemics , COVID-19/complications , RNA, Viral , Diabetes Mellitus/epidemiology , Diabetes Mellitus/therapy , Hyperglycemia/complications , Inflammation/complications
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