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Diabetes Mellitus Increases Risk of Mortality and Respiratory Failure Study Finds

According to a new Philippine study, diabetes mellitus (DM) increases the risk of mortality and respiratory failure, as well as the need for intensive care, in patients with the coronavirus illness 2019 (COVID-19).


Diabetes Mellitus Increases Risk of Mortality and Respiratory Failure Study Finds
Image: COVID-19 Patient with Diabetes | InStyleHealth

The researchers compared the outcomes of 2,191 COVID-19 patients with DM (median age 61 years, 44.5 percent women) against 8,690 patients without DM in a subgroup analysis of the Philippine CORONA Study (median age 48 years, 47.47 percent women). Mortality, respiratory failure, admission to the intensive care unit (ICU), and length of hospital stay were among the outcomes studied.


During follow-up, 1,702 fatalities (15.6 percent) occurred, with DM patients having a substantially higher in-hospital mortality rate (26.4 percent vs 12.9 percent; p0.001). According to multivariate logistic regression, such event rates were associated with a nearly 50% greater risk of mortality in COVID-19 patients with DM compared to those without (adjusted odds ratio [OR], 1.46, 95 percent confidence interval [CI], 1.28–1.68; p0.001).


Respiratory failure (29.9% vs 10.9 percent; p0.001; adjusted OR, 1.67, 95 percent CI, 1.46–1.90) and ICU hospitalization (33.7 percent vs 11.5 percent; adjusted OR, 1.80, 95 percent CI, 1.59–2.05) were also substantially more probable in the DM group.


Furthermore, in COVID-19 patients with DM, the duration of ventilator dependency (median, 14 vs 12 days; p=0.002) and hospital stay (median, 14 vs 13 days; p0.001) were both considerably longer.


Because only severe and critical patients are admitted to the hospital, the study's inclusion of hospitalized COVID-19 patients may have overstated the impact of DM on respiratory failure and mortality. Other confounders, such as greater levels of medication use in diabetics, macrovascular and microvascular problems, and a history of diabetic emergencies, were not taken into account in the study.


"Future studies focusing on the aforementioned criteria are needed to further clarify the role and interaction between the presence of DM, DM complications, and the level of glycemic control on clinical outcomes among COVID-19 patients," the researchers wrote.


Source: Sci Rep 2021;11:24436

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