RESUMO
BACKGROUND: The objectives of the current study were to assess the severity and clinical characteristics of coronavirus disease 2019 (COVID-19) among Saudi adults with type 2 diabetes mellitus (T2DM) in Jazan region, Saudi Arabia. METHODS: This retrospective cohort study included 412 patients with COVID-19 selected randomly from the Health Electronic Surveillance Network system, which contains the primary data on COVID-19 infections in Jazan. RESULTS: COVID-19 disease duration was significantly longer in patients with T2DM (meanâ=â10.7âdays) compared with those without T2DM (meanâ=â8.3âdays) (Pâ=â.01). Six (7%) patients experienced an increase in blood glucose concentrations and had to escalate their total daily insulin dose accordingly. Median fasting and random blood glucose levels increased after infection with COVID-19 (pre-COVID medianâ=â119 and 172âmg/dL, respectively; post-COVID medianâ=â148 and 216âmg/dL, respectively) (Pâ=â.02). The total insulin dose pre-COVID (medianâ=â42âunits/d) increased after infection with COVID-19 (medianâ=â58âunits/d) (Pâ=â.01). Most patients with T2DM had clinical COVID-19 symptoms (91%) and the remainder (9%) were asymptomatic. A large proportion (80%) of T2DM patients with mild COVID-19 symptoms self-isolated at home. COVID-19 patients with T2DM (11%) who had an oxygen saturation of ≤ 90% and admitted to the intensive care unit were higher than those without T2DM (5%) (Pâ=ââ<â.001). COVID-19 patients with T2DM (9%) had higher mortality rate than COVID-19 patients without T2DM (1%) (Pâ=ââ<â.001). CONCLUSION: COVID-19 patients with T2DM were associated with a higher risk of admission to the intensive care unit and mortality than COVID-19 patients without T2DM.
Assuntos
COVID-19 , Diabetes Mellitus Tipo 2 , Insulinas , Adulto , Glicemia , COVID-19/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Humanos , Estudos Retrospectivos , SARS-CoV-2 , Arábia Saudita/epidemiologiaRESUMO
ABSTRACT: The development of pulmonary fibrosis is a rare complication of the novel coronavirus disease 2019 (COVID-19). Limited information is available in the literature about that, and the present study aimed to address this gap.This case-control study included 64 patients with post-COVID-19 pulmonary fibrosis who were hospitalized for COVID-19.The percentage of patients aged ≥65âyears (44%) who demised was higher than those who survived (25%). Male patients (62%) had higher mortality than female patients (37%). The most frequently reported clinical symptoms were shortness of breath (98%), cough (91%), and fever (70%). Most COVID-19 patients with pulmonary fibrosis (81%) were admitted to an intensive care unit (ICU), and 63% required mechanical ventilation. Bilateral lung infiltrates (94%), "ground glass" opacity (91%), "honeycomb" lung (25%), and pulmonary consolidation (9%) were commonly identified in COVID-19 patients with pulmonary fibrosis who survived. The findings for computed tomography and dyspnea scale were significantly higher in severe cases admitted to the ICU who required mechanical ventilation. A higher computerized tomography score also correlated significantly with a longer duration of stay in hospital and a higher degree of dyspnea. Half of the COVID-19 patients with pulmonary fibrosis (50%) who survived required oxygen therapy, and those with "honeycomb" lung required long-term oxygen therapy to a far greater extent than others. Cox regression revealed that smoking and asthma were significantly associated with ICU admission and the risk of mortality.Post-COVID-19 pulmonary fibrosis is a severe complication that leads to permanent lung damage or death.