Characteristics and outcomes of diabetic patients infected by the SARS-CoV-2
Authors: Saloua Elamari, Imane Motaib, Saad Zbiri, Karim Elaidaoui, Asmaa Chadli, Chafik Elkettani
Journal: Pan Afr Med J (2020)
Keywords: covid-19, diabetes, sars-cov-2, severity
MeSH terms: Betacoronavirus, Coronavirus Infections / epidemiology, Diabetes Mellitus / epidemiology, Pneumonia, Viral / epidemiology, Case Reports, Observational Study, Age Factors, C-Reactive Protein / analysis, COVID-19, Cardiovascular Diseases / epidemiology, Coronavirus Infections / blood, Coronavirus Infections / complications, Coronavirus Infections / mortality, Critical Care / statistics & numerical data, Diabetes Complications / blood, Diabetes Complications / epidemiology, Diabetes Complications / mortality, Diabetes Mellitus / blood, Diabetes Mellitus / mortality, Ferritins / blood, Fibrin Fibrinogen Degradation Products / analysis, Humans, Hypertension / epidemiology, L-Lactate Dehydrogenase / blood, Middle Aged, Morocco / epidemiology, Oxygen / therapeutic use, Pandemics, Pneumonia, Viral / blood, Pneumonia, Viral / complications, Pneumonia, Viral / mortality, Procalcitonin / blood, Respiration, Artificial / statistics & numerical data, Retrospective Studies, SARS-CoV-2, Thromboembolism / epidemiology, Fibrin Fibrinogen Degradation Products, Procalcitonin, fibrin fragment D, C-Reactive Protein, Ferritins, L-Lactate Dehydrogenase, Oxygen

Diabetes is considered a risk factor for complications due to COVID-19. In order to clarify this association, we are exploring the characteristics, the clinical signs, the outcomes and death in diabetic patients with COVID-19. In this retrospective observational study we are evaluating the demographic characteristics, the comorbidities of the patients, the clinical signs of the infection, the signs of clinical severity, the biological assessment at admission, the treatment, the outcomes and the deaths of 133 patients with COVID-19, of which 25 (19,4%) had diabetes. In the compared COVID-19 patients, with and without diabetes, the patients with diabetes were older, had higher blood pressure and more cardio-vascular diseases. Severe forms were more present in diabetic patients (56% versus 27.1%). Weight loss was higher in diabetic patients (6kg versus 3kg). Biologically, diabetic patients had higher levels of C-reactive protein (28 versus 5.8mg/l), procalcitonin (0.28 versus 0,13ng/l), ferritin (501 versus 140ng/ml), lactic dehydrogenase (268 versus 226IU/l) and of D. dimer (665 versus 444μg/l). Diabetic patients required more oxygen therapy (60% versus 26.9%), more mechanical ventilation (20% versus 8.3%) and more frequent admission to the intensive care unit (60% versus 27.8%). They presented more thromboembolic complications (12% versus 9%) but there were not significant differences in the other outcomes and in death rates. The excess of morbidity and mortality due to diabetes was still not fully clarified; the role of demographic factors, the interaction of mediations with ACE-2 receptors and the role of co-morbidities will all need to be studied in order to identify the patient at risk profile, i.e. who can develop severe forms of the diseases and more outcomes. The early identification of a possible hyper inflammation could be very valuable. More attention should be paid to patients with COVID-19 with diabetes because they are at a high risk of complications.