tetano
Editor, Senior Moderator
PLoS One
. 2023 Jun 15;18(6):e0286797.
doi: 10.1371/journal.pone.0286797. eCollection 2023. The effect of diabetes mellitus on COVID-19 mortality among patients in a tertiary-level hospital in Bandung, Indonesia
Maya Kusumawati[SUP] 1 [/SUP], Raspati Cundarani Koesoemadinata[SUP] 2 3 [/SUP], Zuhaira Husna Fatma[SUP] 2 [/SUP], Evan Susandi[SUP] 4 [/SUP], Hikmat Permana[SUP] 1 [/SUP], Nanny Natalia Mulyani Soetedjo[SUP] 1 2 [/SUP], Arto Yuwono Soeroto[SUP] 5 [/SUP], Begawan Bestari[SUP] 6 [/SUP], Basti Andriyoko[SUP] 2 7 [/SUP], Bachti Alisjahbana[SUP] 2 8 [/SUP], Yovita Hartantri[SUP] 2 8 [/SUP]
Affiliations
Immune system dysregulation in people with diabetes mellitus (DM) increases the risk of acquiring severe infection. We compared the clinical characteristics and laboratory parameters of coronavirus disease 2019 (COVID-19) patients with and without DM and estimated the effect of DM on mortality among COVID-19 patients. A retrospective cohort study collecting patients' demographic, clinical characteristics, laboratory parameters and treatment outcomes from medical records was conducted in a hospital in Bandung City from March to December 2020. Univariable and multivariable logistic regression was performed to determine the association between DM and death. A total of 664 COVID-19 patients with positive real-time reverse transcription polymerase chain reaction for severe acute respiratory syndrome coronavirus 2 were included in this study, of whom 147 were with DM. Half of DM patients presented HbA1c ≥10%. DM patients were more likely to present with comorbidities and severe to critical conditions at admission (P <0.001). Laboratory parameters such as neutrophil-lymphocyte count ratio, C-reactive protein, D-dimer, ferritin, and lactate dehydrogenase were higher in the DM group. In the univariate analysis, variables associated with death were COVID-19 severity at baseline, neurologic disease, DM, age ≥60 years, hypertension, cardiovascular disease, and chronic kidney disease. DM remained associated with death (aOR 1.82; 95% CI 1.13-2.93) after adjustment with sex, age, hypertension, cardiovascular disease, and chronic kidney disease. In conclusion, COVID-19 patients with DM are more likely to present with a very high HbA1c, comorbidities, and severe-critical illness. Chronic inflammation in DM patients may be aggravated by the disruption of immune response caused by COVID-19, leading to worse laboratory results and poor outcomes.
. 2023 Jun 15;18(6):e0286797.
doi: 10.1371/journal.pone.0286797. eCollection 2023. The effect of diabetes mellitus on COVID-19 mortality among patients in a tertiary-level hospital in Bandung, Indonesia
Maya Kusumawati[SUP] 1 [/SUP], Raspati Cundarani Koesoemadinata[SUP] 2 3 [/SUP], Zuhaira Husna Fatma[SUP] 2 [/SUP], Evan Susandi[SUP] 4 [/SUP], Hikmat Permana[SUP] 1 [/SUP], Nanny Natalia Mulyani Soetedjo[SUP] 1 2 [/SUP], Arto Yuwono Soeroto[SUP] 5 [/SUP], Begawan Bestari[SUP] 6 [/SUP], Basti Andriyoko[SUP] 2 7 [/SUP], Bachti Alisjahbana[SUP] 2 8 [/SUP], Yovita Hartantri[SUP] 2 8 [/SUP]
Affiliations
- PMID: 37319126
- DOI: 10.1371/journal.pone.0286797
Immune system dysregulation in people with diabetes mellitus (DM) increases the risk of acquiring severe infection. We compared the clinical characteristics and laboratory parameters of coronavirus disease 2019 (COVID-19) patients with and without DM and estimated the effect of DM on mortality among COVID-19 patients. A retrospective cohort study collecting patients' demographic, clinical characteristics, laboratory parameters and treatment outcomes from medical records was conducted in a hospital in Bandung City from March to December 2020. Univariable and multivariable logistic regression was performed to determine the association between DM and death. A total of 664 COVID-19 patients with positive real-time reverse transcription polymerase chain reaction for severe acute respiratory syndrome coronavirus 2 were included in this study, of whom 147 were with DM. Half of DM patients presented HbA1c ≥10%. DM patients were more likely to present with comorbidities and severe to critical conditions at admission (P <0.001). Laboratory parameters such as neutrophil-lymphocyte count ratio, C-reactive protein, D-dimer, ferritin, and lactate dehydrogenase were higher in the DM group. In the univariate analysis, variables associated with death were COVID-19 severity at baseline, neurologic disease, DM, age ≥60 years, hypertension, cardiovascular disease, and chronic kidney disease. DM remained associated with death (aOR 1.82; 95% CI 1.13-2.93) after adjustment with sex, age, hypertension, cardiovascular disease, and chronic kidney disease. In conclusion, COVID-19 patients with DM are more likely to present with a very high HbA1c, comorbidities, and severe-critical illness. Chronic inflammation in DM patients may be aggravated by the disruption of immune response caused by COVID-19, leading to worse laboratory results and poor outcomes.