Diabetes, Metabolic Syndrome and Obesity (Jan 2024)
Assessment of the Negative Factors for the Clinical Outcome in Patients with SARS-CoV-2 Infection and Type 2 Diabetes Mellitus
Abstract
Oana Albai,1– 3 Adina Braha,1,2 Bogdan Timar,1– 3 Alexandra Sima,1– 3 Loredana Deaconu,1 Romulus Timar1– 3 1Department of Second Internal Medicine- Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, ”victor Babes” University of Medicine and Pharmacy, Timisoara, 300041, Romania; 2Department of Diabetes, Nutrition and Metabolic Diseases Clinic, ”Pius Brînzeu” Emergency Clinical County University Hospital, Timisoara, 300723, Romania; 3Centre for Molecular Research in Nephrology and Vascular Disease/MOL-NEPHRO-VASC, ”Victor Babes” University of Medicine and Pharmacy, Timisoara, 300041, RomaniaCorrespondence: Adina Braha, Department of Second Internal Medicine- Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, Timisoara, 300041, Romania, Email [email protected]: Patients with diabetes mellitus (DM) are more susceptible to viral and bacterial infections, facing a more severe prognosis and higher mortality rates. The study’s main aim was to evaluate the survival and mortality rates of patients with type 2 diabetes (T2DM) and SARS-CoV-2 virus infection alongside the main factors influencing the prognosis.Patients and Methods: The present study included 186 patients with T2DM and SARS-CoV-2 virus infection admitted to the COVID-19 Department of the “Pius Brînzeu” Emergency Clinical County University Hospital between November 2020 and March 2021. Patients had investigations performed upon arrival in the emergency room and during hospitalization. We analyzed the risk of negative prognosis based on clinical data (oxygen saturation (SatO2), respiratory rate (RR), lung damage), glycemic control (HbA1c, glycemia at hospital admission), and the duration of T2DM.Results: The mortality rate in the studied group was 36.6%. All deceased patients had previously been diagnosed with hypertension; 95.58% had a body mass index (BMI) greater than 25 kg/m2, and 79.41% presented with cardiovascular disease (CVD). Compared to those who recovered, statistically significant differences were observed in BMI, glycemic levels at admission, glycosylated hemoglobin levels (HbA1c), SatO2, RR, and lung damage. Valid statistically significant predictors for death in T2DM patients with COVID-19 were hyperglycemia at admission > 198mg/dl, HbA1c> 8.6%, and SatO2≤ 87%.Conclusion: SatO2, glycemia at hospital admission, and HbA1c had the highest sensitivity and specificity to predict the prognosis of T2DM patients with SARS-CoV-2 infection. Glycemic control is essential in the prognosis of patients with DM and COVID-19 infection. The prognosis was worse if other comorbidities were associated, especially hypertension and CVD.Keywords: SARS-CoV-2 infection, type 2 diabetes mellitus, negative prognostic factors, mortality rate
