Table 2: Main studies reporting characteristics of patients with diabetes and COVID-19 14-19 Table 2: Main studies reporting characteristics of patients with diabetes and COVID-19 14-19 Table 2: Main studies reporting characteristics of patients with diabetes and COVID-19 14-19
Study Population Main findings
Wang F, et al. Prospective observational, China.
28 patients with COVID-19 and diabetes.
A. Mean (SD) age 68.6 (9.0) years, 75% males. B.17 (60.7%) had comorbidities: hypertension (53.6%), CVD (14.3%), cerebrovascular disease (14.3%), chronic pulmonary disease (14.3%). C. Common symptoms were: fever (92.9%), dry cough (82.1%), fatigue (64.3%), dyspnoea (57.1%), anorexia (57.1%), diarrhoea (42.9%), expectoration (25.0%) and nausea (21.4%). C. 14 patients admitted to ICU, of whom 11 received non-invasive and 7 received mechanical ventilation. D. 12 patients died in ICU, no mortality in non-ICU patients, with ICU mortality rate 86% and overall mortality rate 43%. E. Mean (SD) HbA1c 7.5% (1.2) in non-ICU and 7.3% (0.9) in ICU, p=0.70. F. Mean (SD) RBG 13.7 (5.1) in ICU vs 9.8 (3.4) in ICU patients, P=0.03.
Yan Y, et al. Retrospective observational, China.
193 patients with severe COVID-19, 48 with diabetes mellitus.
Patients with compared to those without diabetes were: A. Significantly older, median (IQR) age 70 (62-77) vs 64 (49-73) years, p<0.001. B. Have more comorbidities (60.4% vs 44.8%, p=0.06), hypertension (50% vs 33.8% < p=0.45), CVD (27.1% vs 12.4, p=0.016, cerebrovascular disease (10.4% vs 2.1%, p=0.036). C. Have significantly more ICU admission (66.7% vs 41.4%, p=0.002). D. Required more mechanical ventilation (81.3% vs 49%, p<0.001). E. Significantly higher mortality (81.3% vs 47.6%, p<0.001). F. Median (IQR) HbA1c 7.2% (6.7-8.3) vs 5.8% (5.5-6.1), p<0.001.
Chen Y, et al. Retrospective observational, China.
Total 904 patients with COVID-19, 136 with diabetes mellitus.
A. Patients with were significantly older than those without diabetes (66 vs 56 years, p<0.001), had more history of hypertension (61.2% vs 32.5%, p<0.001) and higher HbA1c (7.3% vs 5.9%, p<0.001). B. Risk factors for higher mortality of patients with diabetes were older age (adjusted OR 1.09, 95% CI 1.04 to 1.15) per year increase; P=0.001) and elevated CRP (1.12, 1.0 to 1.24, P=0.043). C. Insulin usage was associated with poor prognosis defined as progression to severe or critical illness (OR 3.58, 95% CI 1.37 to 9.35, P=0.009) but not with mortality. D. ACEI or ARBs use had no impact on outcomes.
Holman N, et al National diabetes and mortality data, England
265,090 people with type 1 and 2,889,210 with type 2 diabetes, all covid-19 positive.
A. Mortality rate 0.16% in type 1 and 0.32% in type 2 diabetes. B. Adjusted mortality HR of HbA1c >86 mmol/mol compared to HbA1c 48-53 mmol/mol 2.19 (95% CI 1.46 to 3.29) for type 1 and 1.62 (1.48 to 1.79) for type 2 diabetes. C. U-shaped relation between BMI and mortality, HRs for BMI >40 kg/m2 compared to 25-29.9 kg/m2 2.15 (95% 1.37 to 3.36) and 1.46 (1.50 to 1.79) for type 1 and type 2 respectively.
Cariou B, et al nationwide 53 centres, observational, France
1,317 hospitalised patients with covid-19 and diabetes, primary outcome mechanical ventilation and/or death within 7 days of admission.
A. Mean (SD) age 69.8 (13.0) years, 64.9% men, median BMI 28.4 (25th-75th percentile 25.0-32.7) kg/m², type 2 diabetes (88.5%). B. Microvascular and macrovascular diabetic complications 46.8% and 40.8%, respectively. C. Primary outcome encountered in 29.0% (95% CI 26.6 to 31.5), mortality 10.6% (9.0 to 12.4), 18.0% (16.0 to 20.2) discharged on day7. D. In multivariable analyses, only BMI positively associated with primary outcome (OR 1.28, 95% CI 1.10 to 1.47). E. Age (OR 2.48, 95% CI 1.74 to 3.53), treated obstructive sleep apnoea (2.80, 1.46 to 5.38), microvascular (2.14, 1.16 to 3.94) and macrovascular complications (2.54, 1.44 to 4.50) were independently associated with mortality risk on day 7.
Bode B, et al retrospective observational US
Total 1,122 patients in 88 US hospitals, 451 with diabetes or uncontrolled hyperglycaemia.
A. mortality rate 28.8% in 184 diabetes and/or uncontrolled hyperglycemia patients, compared to 6.2% of 386 patients without diabetes or hyperglycemia (P <0.001). B. Mortality rate 41.7% in uncontrolled hyperglycaemia and 14.8% in diabetes patients, p<0.001. C. LOS was longer in patients with uncontrolled hyperglycaemia or diabetes compared to those without (5.7 vs 4.3 days, p<0.001).