The outcomes of patients with diabetes mellitus in The Philippine CORONA Study
Authors: Espiritu Adrian I. , Chiu Harold Henrison C. , Sy Marie Charmaine C. , Anlacan Veeda Michelle M. ,   The Philippine CORONA Study Group, Macalintal Corina Maria Socorro A. , Robles Joanne B. , Cataniag Paulo L. , Flores Manolo Kristoffer C. , Tangcuangco-Trinidad Noreen Jhoanna C. , Juangco Dan Neftalie A. , Paas Giuliani Renz G. , Chua Audrey Marie U. , Estrada Valmarie S. , Mejia Philip Rico P. , Reyes Therese Franz B. , Cañete Maria Teresa A. , Zapata Ferdinand Renfred A. , Castillo Franko Eugenio B. , Esagunde Romulo U. , Gantioque Jean B. , Abbariao Maritoni C. , Acebuque Geramie M. , Corral Evram V. , Escasura Marian Irene C. , Ong Marissa T. , Fowler Krizelle , Pineda Arnold Angelo M. , Aradani Khasmeen D. , Catindig Joseree-Ann S. , Cinco Mark Timothy T. , Ramos Mark Erving H. , Cruz Romulus Emmanuel H. , Dantes Marita B. , Francisco Norberto A. , Teleg Rosalia A. , Bellosillo Krisverlyn B. , Delfino Jean Paolo M. , Diesta Cid Czarina E. , Espiritu-Picar Rosalina B. , Gamboa Julie Anne V. , Matute Cara Camille M. , Padilla Franzelle P. , Punsalan John Joshua Q. , Collantes Ma. Epifania V. , Que Charmaine B. , Sampao Hanifa A. , Maria Maxine Camela S. Sta. , Fuentes Marita M. , Manzano Jennifer Justice F. , Umali Rizza J. , Molina Marc Conrad C. , Minerva-Ang Hazel Claire , Surdilla Arturo F. , Talabucon Loreto P. , Wabe Natasha F. , Manuel Maria Victoria G. , Pajantoy Al Inde John A. , Roque Josephine Cecilia V. , Yambao Paul Emmanuel L. , Banday Christian Paul B. , Cipriano Chritopher C. , Pangandaman Nehar A. , Wasil Avery Gail C. , Inocian Elrey P. , Vatanagul Jarungchai Anton S. , Apor Almira Doreen Abigail O. , Dioquino Carissa Paz C. , Cruz Prinz Andrew M. Dela , Yumul Maricar P. , Carandang-Concepcion Ma. Alma E. , Desquitado Ma. Caridad V. , Julao Carl Kevin L. , Bornales Dante P. , Maylem Generaldo D. , Cuntapay Mark Joseph F. , Lao-Reyes Annabelle Y. , Lee Aileen Mae B. , Manlegro Nadia O. , Pelere Dave Mar L. , Laxamana Lina C. , Que Diana-Lynn S. , Yu Jeryl Ritzi T. , Martinez Ma. Socorro C. , Matic Alexandria E. , Perez John Angelo Luigi S. , Constantino Glenn Anthony A. , Olano Aldanica R. , Quiles Liz Edenberg P. , Roxas Artemio A. , Soliven Jo Ann R. , Montojo-Tamayo Michael Dorothy Frances , Joson Ma. Lourdes C. , Evangelista Jojo R. , Nuñez Ma. Clarissa B. , Olaivar Marietta C. , Perez Dominique Q. , Armeña Mark Deneb O. , Barja Robert A. , Abejero Joshua Emmanuel E. , Eribal Maritzie R. , Alava Ryndell G. , Kalbi Muktader A. , Radja Nasheera W. , Sali Mohammad Elshad S. , Jamora Roland Dominic G. 
Published: December 2021

Patients diagnosed with diabetes mellitus (DM) who are infected with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) belong to the most vulnerable patient subgroups. Emerging data has shown increased risks of severe infections, increased in ICU admissions, longer durations of admission, and increased mortality among coronavirus disease 2019 (COVID-19) patients with diabetes. We performed a subgroup analysis comparing the outcomes of patients diagnosed with DM (n = 2191) versus patients without DM (n = 8690) on our data from our study based on a nationwide, comparative, retrospective, cohort study among adult, hospitalized COVID-19 patients involving 37 hospital sites from around the Philippines. We determined distribution differences between two independent samples using Mann–Whitney U and t tests. Data on the time to onset of mortality, respiratory failure, intensive care unit (ICU) admission were used to build Kaplan–Meier curves and to compute for hazard ratios (HR). The odds ratios (OR) for longer ventilator dependence, longer ICU stay, and longer hospital stays were computed via multivariate logistic regression. Adjusted hazard ratios (aHR) and ORs (aOR) with 95% CI were calculated. We included a total of 10,881 patients with confirmed COVID-19 infection (2191 have DM while 8690 did not have DM). The median age of the DM cohort was 61, with a female to male ratio of 1:1.25 and more than 50% of the DM population were above 60 years old. The aOR for mortality was significantly higher among those in the DM group by 1.46 (95% CI 1.28–1.68; p < 0.001) as compared to the non-DM group. Similarly, the aOR for respiratory failure was also significantly higher among those in the DM group by 1.67 (95% CI 1.46–1.90). The aOR for developing severe COVID-19 at nadir was significantly higher among those in the DM group by 1.85 (95% CI 1.65–2.07; p < 0.001). The aOR for ICU admission was significantly higher among those in the DM group by 1.80 (95% CI 1.59–2.05) than those in the non-DM group. DM patients had significantly longer duration of ventilator dependence (aOR 1.33, 95% CI 1.08–1.64; p = 0.008) and longer hospital admission (aOR 1.13, 95% CI 1.01–1.26; p = 0.027). The presence of DM among COVID-19 patients significantly increased the risk of mortality, respiratory failure, duration of ventilator dependence, severe/critical COVID-19, ICU admission, and length of hospital stay.