Studies have confirmed COVID-19 patients with diabetes are at higher risk of mortality than their non-diabetic counterparts. However, data-driven evidence of factors associated with increased mortality risk among hospitalized COVID-19 patients with diabetes is scarce in South Korea. This study was conducted to determine the mortality rate and identify risk factors of mortality among hospitalized COVID-19 patients with type 2 diabetes in Gyeongsangbuk-do province, South Korea. In this hospital-based, cross-sectional study, we enrolled a total of 324 patients with confirmed COVID-19, hospitalized at two of the tertiary level healthcare facilitates of Gyeongsangbuk-do, South Korea from 18 February to 30 June 2020. Demographic and clinical data and laboratory profiles were analyzed and multivariate logistic regression analysis was used to identify risk factors of mortality among diabetic patients with COVID-19. Of the 324 patients, 55 (16.97%) had diabetes mellitus. The mean age of all study subjects was 55 years, and the mean age of those with diabetes was greater than that of those without (69.8 years vs. 51.9 years). Remarkably, the mortality rate was much higher among those with diabetes (20.0% vs. 4.8%). Multivariate logistic regression analysis revealed that an older age (≥70 years) and a high serum lactate dehydrogenase (LDH) levels significantly predicted mortality among hospitalized COVID-19 patients with diabetes. Our study cautions more attention to be paid to patients with diabetes mellitus hospitalized for COVID-19, especially those aged ≥ 70 years and those with a high serum LDH level, to reduce the risk of mortality.

We examined the kinetics of contrast agent elimination during hemodialysis in 7 patients with end-stage renal disease on regular hemodialysis treatment (group I) and in 13 patients with impaired renal function (serum creatinine 214-657 μmol/l; group II). The nonionic agent iohexol was administered at a dose of 0.4-4.5 g/kg, and a 6-hour hemodialysis was performed with 1-18 h delay. This procedure removed 60-90% (mean 77%) of the iohexol present in the circulation at the start of dialysis treatment. The mean extraction ratio across the dialysis membrane was 0.47 and was inversely related to blood flow. The total clearance of iohexol was 70.4 ± 24.6 ml/min and was very close to dialyzer clearance, as estimated from blood flow and extraction ratio. The plasma iohexol level after dialysis was related to the dose administered, iohexol clearance, and the patients’ body weight. During peritoneal dialysis (36-60 liters dialysis fluid), 43-72% of the iohexol dose was removed from the patients’ circulation. In patients of group II no further impairment of the renal function (increase of serum creatinine) in conjunction with angiography was observed. We conclude that hemodialysis and peritoneal dialysis are effective methods for removal of iohexol. Our observations suggest also that accelerated elimination of contast media by prophylactic dialysis can be beneficial in preventing further reduction in renal function after angiographic procedures in high-risk patients.

Background Coronavirus disease 2019 (COVID-19) was first reported in December 2019 in China, and then it has disseminated worldwide. In Korea, a religious group-related super-spreading event triggered a sudden outbreak in Daegu city and Gyeongsangbuk-do in southeast Korea. This study was undertaken to document the clinical characteristics of patients hospitalized in Gyeongsangbuk-do. Methods Three hundred and fifty-two patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection hospitalized at Dongguk University Gyeongju Hospital or at the Andong Medical Center between February 18th and June 30th were enrolled in this study. Medical records were reviewed and demographic and clinical features, including comorbidities, symptoms, radiological and laboratory findings on admission were analyzed. In addition, we sought to identify risk factors of mortality. Results Mean age of the 352 study subjects was 56 years (range, 14–95). The mortality rate was 6.8% and mean age at death was 81 years (range, 57–91). The most common symptom was cough (31.8%) followed by a febrile sensation (28.4%), sputum (17.0%), sore throat (15.6%), and myalgia (13.1%). Eighty-one (23.0%) patients were asymptomatic, but a half of these patients exhibited pneumonic infiltration at presentation. Chest radiology showed no active lesion in 41.8% of the study subjects, bilateral pneumonia in 46.9%, and unilateral pneumonic infiltration in 11.4%. Among 24 patients that died, 18 subjects were transferred from a care facility. An age of ≥ 70 years, previous history of malignancy or diabetes, and fever (≥ 37.5°C) on admission were found to be significant risk factors of mortality. Conclusion Patients aged ≥ 70 years, those with fever on admission, and patients with an underlying malignancy or diabetes were found to be more likely to succumb to COVID-19. Elderly in care facilities or hospitalized patients with an underlying disease should receive more attention and be considered for preventive quarantine.

Background: This study was a multicenter, parallel-group, double-blind, double-dummy, randomized, noninferiority trial to evaluate the efficacy and safety of γ-linolenic acid (GLA) relative to α-lipoic acid (ALA) over a 12-week treatment period in type 2 diabetes mellitus (T2DM) patients with painful diabetic peripheral neuropathy (DPN). Methods: This study included 100 T2DM patients between 20 and 75 years of age who had painful DPN and received either GLA (320 mg/day) and placebo or ALA (600 mg/day) and placebo for 12 weeks. The primary outcome measures were mean changes in pain intensities as measured by the visual analogue scale (VAS) and the total symptom scores (TSS). Results: Of the 100 subjects who initially participated in the study, 73 completed the 12-week treatment period. Per-protocol analyses revealed significant decreases in the mean VAS and TSS scores compared to baseline in both groups, but there were no significant differences between the groups. The treatment difference for the VAS (95% confidence interval [CI]) between the two groups was −0.65 (−1.526 to 0.213) and the upper bound of the 95% CI did not exceed the predefined noninferiority margin (δ1=0.51). For the TSS, the treatment difference was −0.05 (−1.211 to 1.101) but the upper bound of the 95% CI crossed the noninferiority margin (δ2=0.054). There were no serious adverse events associated with the treatments. Conclusion: GLA treatment in patients with painful DPN was noninferior to ALA in terms of reducing pain intensity measured by the VAS over 12 weeks.

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