Assessment of the Negative Factors for the Clinical Outcome in Patients with SARS-CoV-2 Infection and Type 2 Diabetes Mellitus

Abstract

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/m 2 , 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.

Colliding Challenges: An Analysis of SARS-CoV-2 Infection in Patients with Pulmonary Tuberculosis versus SARS-CoV-2 Infection Alone

“…Furthermore, diabetic patients with SARS-CoV-2 infection are expected to present worse symptomatology and even worse outcomes. SpO2 at hospital admission, along with glycemia and glycosylated hemoglobin, seem to have the highest sensitivity and specificity in predicting the prognosis of type 2 DM patients with SARS-CoV-2 infection [81]. Associating TB and type 2 DM in the context of SARS-CoV-2 has not been studied sufficiently.…”

Predictive Factors of Anxiety and Depression in Patients with Type 2 Diabetes Mellitus

“…Poor glycemic control with high glycemic variability and numerous complications and comorbidities in patients with DM decreases the ability to defend against infections, including viral infections, such as infection with the new coronavirus (SARS-CoV-2). Chronic inflammation is exacerbated during infection with the new coronavirus, leading to severe complications, and micronutrient deficiencies are associated with increased virulence and negative prognosis [21][22][23][24].…”