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The relationship between diabetes and clinical outcomes in COVID-19: a single-center retrospective analysis.

Authors
  • Fox, Tamaryn1
  • Ruddiman, Kathleen2
  • Lo, Kevin Bryan2
  • Peterson, Eric2
  • DeJoy, Robert 3rd2
  • Salacup, Grace2
  • Pelayo, Jerald2
  • Bhargav, Ruchika2
  • Gul, Fahad2
  • Albano, Jeri2
  • Azmaiparashvili, Zurab2
  • Anastasopoulou, Catherine2, 3, 4
  • Patarroyo-Aponte, Gabriel2, 4, 5
  • 1 Department of Medicine, Einstein Medical Center Philadelphia, 5501 Old York Road, Philadelphia, PA, 19141, USA. [email protected]
  • 2 Department of Medicine, Einstein Medical Center Philadelphia, 5501 Old York Road, Philadelphia, PA, 19141, USA.
  • 3 Department of Endocrinology, Einstein Medical Center Philadelphia, Philadelphia, USA.
  • 4 Sidney Kimmel College of Thomas Jefferson University, Philadelphia, PA, USA.
  • 5 Pulmonary, Critical Care and Sleep Medicine, Einstein Medical Center Philadelphia, Philadelphia, USA.
Type
Published Article
Journal
Acta diabetologica
Publication Date
Aug 17, 2020
Identifiers
DOI: 10.1007/s00592-020-01592-8
PMID: 32804317
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Coronavirus disease 19 (COVID-19) has become a pandemic. Diabetic patients tend to have poorer outcomes and more severe disease (Kumar et al. in Diabetes Metab Syndr 14(4):535-545, 2020. https://doi.org/10.1016/j.dsx.2020.04.044 ). However, the vast majority of studies are representative of Asian and Caucasian population and fewer represent an African-American population. In this single-center, retrospective observational study, we included all adult patients (> 18 years old) admitted to Einstein Medical Center, Philadelphia, with a diagnosis of COVID-19. Patients were classified according to having a known diagnosis of diabetes mellitus. Demographic and clinical data, comorbidities, outcomes and laboratory findings were obtained. Our sample included a total of 355 patients. 70% were African-American, and 47% had diabetes. Patients with diabetes had higher peak inflammatory markers like CRP 184 (111-258) versus 142 (65-229) p = 0.012 and peak LDH 560 (384-758) versus 499 (324-655) p = 0.017. The need for RRT/HD was significantly higher in patients with diabetes (21% vs 11% p = 0.013) as well as the need for vasopressors (28% vs 18% p = 0.023). Only age was found to be an independent predictor of mortality. We found no significant differences in inpatient mortality p = 0.856, need for RRT/HD p = 0.429, need for intubation p = 1.000 and need for vasopressors p = 0.471 in African-Americans with diabetes when compared to non-African-Americans. Our study demonstrates that patients with COVID-19 and diabetes tend to have more severe disease and poorer clinical outcomes. African-American patients with diabetes did not differ in outcomes or disease severity when compared to non-African-American patients.

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