Clinical characteristics and outcome of hospitalized COVID-19 patients with diabetes: A single-center, retrospective study in Iran

Akbariqomi, Mostafa; Hosseini, Mahboobeh Sadat; Rashidiani, Jamal; Sedighian, Hamid; Biganeh, Hossein; Heidari, Reza; Moghaddam, Mehrdad Moosazadeh; Farnoosh, Gholamreza; Kooshki, Hamid

doi:10.1016/j.diabres.2020.108467

Cited by 54 publications

(70 citation statements)

References 23 publications

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“…In one of the earliest reports of clinical characteristics of COVID-19 from Wuhan China; 14% of 138 patients demonstrated baseline cardiovascular disease and 31% had hypertension [41]. Similar data has been reported in other population studies from Wuhan, China [42][43][44]; Italy [45,46]; Iran [47], United Kingdom [48] and the USA [49] to varying cardiac involvement.…”

Section: Cardiovascular Findings In Covid-19supporting

confidence: 74%

Coronavirus Disease: Epidemiology, Aetiology, Pathophysiology and Involvement of the Cardiovascular System

Gaze¹

2021

Cardiac Diseases - Novel Aspects of Cardiac Risk, Cardiorenal Pathology and Cardiac Interventions

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Since the emergence in China of coronavirus disease (COVID-19) in December 2019; the virus causing the pandemic has infected the human population in almost every country and territory on the globe. At the time of writing there are over 84 million confirmed cases of infection and over 1.8 million deaths globally. Rates of infection differ as does the number of severe cases and subsequent deaths between countries and continents. This is due in part to lockdown measures, social distancing and wearing of face coverings. It is also reflected by how healthcare systems record coronavirus deaths along with access to testing as well as tracking and tracing of infected individuals. Symptoms of COVID-19 include a novel persistent cough, fever and anosmia (loss of smell). In most cases, such symptoms are mild. A small proportion of those who become infected however, have a severe reaction to the disease affecting multiple organ systems and often require respiratory support in the intensive care setting. One such physiological system affected is the cardiovascular system. This is likely due to the increased number of ACE2 receptors in co-morbid cardiac pathologies. ACE2 receptors serve as the entry port for the coronavirus into human cells. Those individuals with underlying cardiovascular risk factors are therefore disproportionately at risk of COVID-19 infection. This chapter reviews the aetiology and epidemiology of the coronavirus infection; potential pathophysiological mechanisms of disease involving the cardiovascular system including the clinical utility of biomarkers, electrocardiography and echocardiography as well as autopsy cardiac pathology and histopathology.

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Section: Cardiovascular Findings In Covid-19supporting

confidence: 74%

Coronavirus Disease: Epidemiology, Aetiology, Pathophysiology and Involvement of the Cardiovascular System

Gaze¹

2021

Cardiac Diseases - Novel Aspects of Cardiac Risk, Cardiorenal Pathology and Cardiac Interventions

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“…After the full text of the articles was read, 119 were excluded due to irrelevance to the current meta-analysis scope, and/or were case reports, reviews, previous meta-analyses, and other disease or lack of the relevant data. Finally, a total of ten publication including 11,755 infected cases with 942 deaths were selected [14,[36][37][38][39][40][41][42][43][44]. The study characteristics of included studies in the present meta-analysis are described in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Proportion and mortality of Iranian diabetes mellitus, chronic kidney disease, hypertension and cardiovascular disease patients with COVID-19: a meta-analysis

Mirjalili

Dastgheib

Shaker

et al. 2021

J Diabetes Metab Disord

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Background Currently, the number of patients with SARS-COV-2 infection has increased rapidly in Iran, but the risk and mortality of SARS-COV-2 infection in Iranian patients with diabetes mellitus (DM), chronic kidney disease (CKD), hypertension and cardiovascular diseases (CVDs) still not clear. The aim of this meta-analysis was to estimate the proportion and mortality of SARS-COV-2 in these patients. Methods A comprehensive literature search was carried out in PubMed, Web of Sciences, Cochrane Library, EMBASE, CNKI, SciELO, and other databases to identify all relevant studies published up to 10 January, 2020. The proportion and mortality in the patients were assessed by odd ratio (OR) and the corresponding 95 % confidence interval (95 % CI). Results A total of ten case-series including 11,755 cases with SARS-COV-2 infection and 942 deaths were selected. Among them, there were total of 791 DM patients with 186 deaths, 225 CKD patients with 45 deaths, 790 hypertension cases with 86 deaths, and 471 CVDs cases with 60 deaths. Pooled data revealed that the proportion of SARS-COV-2 infection in the patients with hypertension, DM, CVDs and CKD were 21.1 %, 16.3 %, 14.0 % and 5.0 %, respectively. Moreover, the SARS-COV-2 infection were associated with an increased risk of mortality in DM (OR = 0.549, CI 95 % 0.448-0.671, p ≤ 0.001) and CKD (OR = 0.552, 95 % CI 0.367-0.829, p = 0.004) patients, but not hypertension and CVDs. There was no publication bias. Conclusions Our pooled data showed that the proportion of SARS-COV-2 infection was the highest in the Iranian patients with hypertension (21.1 %) followed by DM (16.3 %), CVDs (14.0 %) and CKD (5.0 %). Moreover, DM and CKD in patients with SARS-COV-2 infection were associated with a 0.549 and 0.552-fold increase in mortality, respectively. Clinicians in Iran should be aware of these findings, to identifying patients at higher risk and inform interventions to reduce the risk of death. Moreover, well-designed, large-scale and multicenter studies are needed to improve and validate our findings.

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“…595 consecutive hospitalized COVID-19 patients demonstrates that pneumonia and secondary infection were 2 times higher in diabetic than normoglycemic patients, which was parallel with changes in death rate (Akbariqomi et al, 2020). Thus, the adequate diabetes treatment maintaining optimal glucose levels may be an effective method for achieving glycemic targets and reducing mortality in diabetic patients with COVID-19 (Sardu et al, 2020).…”

Section: Clinical Course Of Covid-19 Diabetic Patientsmentioning

confidence: 97%

“…Poorly controlled DM has been linked to inhibited lymphocyte proliferative response to different kinds of stimuli, as well as impaired monocyte/macrophage and neutrophil functions ( Hussain et al, 2020 ). A recent study with 595 consecutive hospitalized COVID-19 patients demonstrates that pneumonia and secondary infection were 2 times higher in diabetic than normoglycemic patients, which was parallel with changes in death rate ( Akbariqomi et al, 2020 ). Thus, the adequate diabetes treatment maintaining optimal glucose levels may be an effective method for achieving glycemic targets and reducing mortality in diabetic patients with COVID-19 ( Sardu et al, 2020 ).…”

Section: Pathophysiology Of Covid-19 In the Lung Of Diabetic Patientsmentioning

confidence: 98%

Pathophysiology of SARS-CoV-2 in Lung of Diabetic Patients

et al. 2020

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Novel coronavirus disease (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Its impact on patients with comorbidities is clearly related to fatality cases, and diabetes has been linked to one of the most important causes of severity and mortality in SARS-CoV-2 infected patients. Substantial research progress has been made on COVID-19 therapeutics; however, effective treatments remain unsatisfactory. This unmet clinical need is robustly associated with the complexity of pathophysiological mechanisms described for COVID-19. Several key lung pathophysiological mechanisms promoted by SARS-CoV-2 have driven the response in normoglycemic and hyperglycemic subjects. There is sufficient evidence that glucose metabolism pathways in the lung are closely tied to bacterial proliferation, inflammation, oxidative stress, and pro-thrombotic responses, which lead to severe clinical outcomes. It is also likely that SARS-CoV-2 proliferation is affected by glucose metabolism of type I and type II cells. This review summarizes the current understanding of pathophysiology of SARS-CoV-2 in the lung of diabetic patients and highlights the changes in clinical outcomes of COVID-19 in normoglycemic and hyperglycemic conditions.

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Clinical characteristics and outcome of hospitalized COVID-19 patients with diabetes: A single-center, retrospective study in Iran

Cited by 54 publications

References 23 publications

Coronavirus Disease: Epidemiology, Aetiology, Pathophysiology and Involvement of the Cardiovascular System

Coronavirus Disease: Epidemiology, Aetiology, Pathophysiology and Involvement of the Cardiovascular System

Proportion and mortality of Iranian diabetes mellitus, chronic kidney disease, hypertension and cardiovascular disease patients with COVID-19: a meta-analysis

Pathophysiology of SARS-CoV-2 in Lung of Diabetic Patients

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