Role of inflammation in determining the severity of COVID-19 infection in patients with diabetes: A comparative study.

There is a need to consider the geographical origins when studying the association between COVID-19 and the comorbid conditions. To examine the role of inflammation in determining the severity of COVID-19 among hospitalized patients with diabetes and compare these roles with those who does not have diabetes. A cross sectional comparative design was used with a convenience sample of 352 patients. Samples were collected from hospitalized patients with COVID-19 who were divided into 2 groups (diabetes and non-diabetes). Data regarding results of selected inflammatory markers and sociodemographic were collected. The severity of COVID-19 differed significantly between the diabetes and non-diabetes groups (Chi square = 25.58 P < .05). There was significant difference in the mean scores of neutrophil counts, monocyte count, Basophil count, erythrocyte sedimentation rate, partial thromboplastin time, C-creative protein, platelets, white blood cells, and mean cellular hemoglobin center between those with and those without diabetes. The diabetes were shown more increased in the predictors and severity of the COVID-19 disease. However, neutrophil to lymphocyte ratio, neutrophil count, and age were the significant predictors of the severity level of COVID-19 among patients with diabetes. In conclusion, our study addressed the influence of having diabetes among hospitalized patients with moderate and severe COVID-19 infection. The results showed that severity of COVID-19 infection was affected by diabetes where those with diabetes had more tendency to suffer from the severe form of the disease rather that the moderate level.

Relationships between Inflammatory Biomarkers and Fatigue among Patients with Moderate and Severe COVID-19.

Background: Patients with moderate or severe COVID-19 infection suffer from varying levels of fatigue; however, there is a lack of understanding regarding the effect of inflammation on fatigue; and whether these relationships differ according to the severity of the infection. Aim: To assess the relationships between selected inflammatory biomarkers and fatigue levels among hospitalized Jordanian patients with moderate or severe COVID-19 infection. Methods: A quantitative cross-sectional design was used. A total of 352 participants were recruited for the study. Data regarding fatigue type and level were collected using the Chalder fatigue scale. Laboratory test results regarding several selected inflammatory biomarkers (e.g., ESR, CRP, IL-6, D-dimer, and others) were collected from patient records. The severity of the COVID-19 infection was determined using the criteria of the Ministry of Health in Jordan based on the results of O2% (oxygen saturation). Results: The mean scores of the total fatigue level significantly differed between the two levels of the severity of COVID-19 infection (moderate and severe levels) (t = -3.0, p < 0.05). Similar findings were observed with physiological fatigue (t = -3.50, p < 0.05), and no significant difference was observed in psychological fatigue. Out of the selected inflammatory markers, only neutrophil and lymphocyte count had a significant influence on total fatigue level. Conclusion: The level and type of fatigue was affected by the severity of the disease. However, the disease process itself represented by the levels of the inflammatory markers showed little influence on fatigue. The implications such as continuous screening of fatigue, and monitoring of the levels of the inflammatory markers are important to assist in diagnosing and managing COVID-19 patients. Furthermore, the relationship between the inflammatory process and fatigue is complex and requires further exploration.