High prevalence of diabetes and other comorbidities in hospitalized patients with COVID-19 in Delhi, India, and their association with outcomes

Mithal, Ambrish; Jevalikar, Ganesh; Sharma, Rutuja; Singh, Avninder; Farooqui, Khalid; Mahendru, Shama; Krishnamurthy, Arvind; Dewan, Arun; Budhiraja, Sandeep

doi:10.1016/j.dsx.2020.12.029

Cited by 59 publications

(64 citation statements)

References 23 publications

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“…Earlier scientific work in a similar population reported increasing age [ 1 , 8 ], male sex [ 12 , 13 ], admission with coronary artery disease [ 1 , 8 ], pre-existing diabetes mellitus, hypertension, kidney disease, cerebral infarction, chronic obstructive pulmonary disease, cancer, and pancreatic problems shows a direct relation with poor outcomes and higher mortality in patients with COVID-19 [ 11 , 14 , 15 ]. Likewise, patients with multiple symptoms, more comorbidities, and advanced age had a higher risk than those without [ 12 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Predictors of critical illness and mortality based on symptoms and initial physical examination for patients with SARS-CoV-2: A retrospective cohort study

Bairwa

Kumar

Ajmal

et al. 2021

Journal of Infection and Public Health

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Introduction An unidentified cluster of pneumonia was identified in Wuhan city of China in the last week of December 2019, named Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-COV-2). The current study explored the predictors associated with critical illness and mortality based on symptoms at the time of admission and initial physical examination findings in patients with SARS-CoV-2. Material and methods A total of 249 records of laboratory-confirmed SARS-COV-2 patients were analyzed. Demographic profile and findings of initial physical examination were collected and analyzed. Bivariate logistic and multivariable stepwise forward regression analysis was used to identify the predictors of critical illness and mortality. Results A total of 249 records of SARS-COV-2 patients were retrospectively studied, of whom 66 (26.5%) developed a critical illness, and 58 (23.29%) died. The mean age of patients was 45.15 (16.34) years; 171 (68.71%) were men. From 27 potential predictors for developing a critical illness, 15 were reported independent predictors for critical illness, and 13 were for increased risk of mortality. Stepwise forward regression reported dyspnea as a single strongest predictor (OR, 5.800, 95% CI-2.724−12.346; p = 0.001, R 2 = 0.272) to develop critical illness. Likewise, the respiratory rate was alone reported as a strong predictor (OR, 1.381, 95% CI- 1.251−1.525; p = 0.000, R 2 = 0.329) for mortality. Conclusions Coronavirus disease is a new challenge to the medical fraternity, leading to significant morbidity and mortality. Knowledge of potential risk factors could help clinicians assess patients' risk with unfavourable outcomes and improve hospitalization decisions in the early stage.

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Section: Introductionmentioning

confidence: 99%

Predictors of critical illness and mortality based on symptoms and initial physical examination for patients with SARS-CoV-2: A retrospective cohort study

Bairwa

Kumar

Ajmal

et al. 2021

Journal of Infection and Public Health

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“…Other hospital-based non-HIV cohorts from India have reported crude mortality rate of 2%-4%. 5,6 Higher mortality rates among HIV-COVID-19 coinfected individuals as compared with those without HIV infection have been reported in several large population-based studies across the world. 2,7,8 A standardized mortality ratio of COVID-19 death associated with HIV was reported to be 2.39 in a large study from South Africa.…”

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confidence: 97%

Short Communication: Coronavirus Disease 19 Among People Living with HIV in Western India: An Observational Cohort Study

Pujari¹,

Gaikwad²,

Chitalikar³

et al. 2021

AIDS Research and Human Retroviruses

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A retrospective cohort study was conducted to assess clinical characteristics and outcomes of coronavirus disease-19 (COVID-19) among people living with HIV (PLHIV) in western India. Out of 86 PLHIV with COVID-19 illness, 19.7% had severe/critical illness and 6 (6.9%) individuals died. Median (interquartile range) age was 51 (47-56) years and 77.6% were male. Eighty-five PLHIV were on antiretroviral treatment with 98% having a viral load <200 copies/mL. Hypertension (HTN) (38.3%) and diabetes mellitus (17.4%) were commonest comorbidities. Fifty-eight percent PLHIV were hospitalized while 6.9% individuals needed intensive care. Presence of medical comorbidity was significantly associated with severe/critical COVID-19, whereas HTN was significantly associated with mortality. Recovery from COVID-19 was documented in 93% PLHIV. In conclusion, PLHIV in western India have similar COVID-19 clinical outcomes as compared with those reported historically among general population. Presence of medical comorbidities rather than HIV-related disease characteristics is associated with severe COVID-19 illness.

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“…In our overall cohort, 17.4% patients had pre-existing DM. The percentage of patients with DM in COVID-19 cohorts has varied from 11 to 42% in different series ( 5 , 6 , 7 , 8 , 25 ). In a retrospective cohort of 584 COVID-19 patients from Wuhan, the number of patients with pre-existing DM was 84 (14.38%) ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

“…In a retrospective cohort of 584 COVID-19 patients from Wuhan, the number of patients with pre-existing DM was 84 (14.38%) ( 19 ). In a study from Delhi, the numbers of patients with pre-existing DM were higher at 189 (47.1%) ( 25 ). In another study from Italy, out of 413 subjects, 107 (25.6%) had diabetes, including 21 who were newly diagnosed ( 8 ).…”

Section: Discussionmentioning

confidence: 99%

“…Patients with moderate and severe disease according to ICMR and WHO grading had a higher plasma glucose than those with asymptomatic or mild disease ( P < 0.0001). In the study from Delhi, patients with diabetes had a higher proportion of severe cases (20.1% vs 9%, P = 0.002), ICU admission (24.3% vs 12.3%, P = 0.002), and oxygen requirement (53.4% vs 28.3%, P < 0.001) ( 25 ). Baseline HbA1c correlated significantly with outcome severity scores (r = 0.136, P = 0.013) although this was not available for our cohort.…”

Section: Discussionmentioning

confidence: 99%

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Effect of plasma glucose at admission on COVID-19 mortality: experience from a tertiary hospital

Kumar

Mittal

Gopalakrishnan

et al. 2021

Endocrine Connections

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Objective: Plasma glucose has been correlated with in-hospital mortality among many diseases including infections. We aimed to study plasma glucose at admission of hospitalized patients with COVID-19 at a tertiary care referral hospital at Jodhpur, India and its relation with mortality. Design: A hospital-based clinical study of plasma glucose of COVID-19 patients conducted from May 15th to June 30th, 2020 after ethical approval. Measurements: Random blood samples at admission were collected for plasma glucose, interleukin-6 (IL-6) and high sensitivity C-reactive protein (hsCRP) after written informed consent. Plasma glucose was analyzed by automated analyzer, IL-6 by chemiluminescent immunoassay and hsCRP by immune-turbidimetric assay. Results: A total of 386 patients studied (female 39.6%); 11.1% had severe disease and 4.1% expired. There were 67 (17.4%) patients with known diabetes mellitus (DM). Patients with history of DM had three times higher mortality (6/66, 9%) than those without DM (10/319, 3.1%). Patients with moderate and severe disease according to ICMR and WHO grading had higher plasma glucose than those with asymptomatic or mild disease (p<0.0001). Plasma glucose levels at admission were significantly higher in non-survivors when compared to those who survived (297±117 vs. 131±73; p<0.0001). COVID-19 patients showed increasing mortality with incremental plasma glucose levels. Hazard ratio for mortality was 1.128 (95%CI 0.86-14.860),1.883 (95%CI 0.209-16.970), and 4.005 (95%CI 0.503-32.677) in random plasma glucose group of >100-200, >200-300 and >300mg/dl respectively compared to those with random plasma glucose of <100mg/dl at admission. Plasma glucose was strongly correlated with hsCRP (p<0.001) and IL-6 (p<0.0001). Conclusions: Plasma glucose at admission in hospitalized COVID-19 patients is a strong predictor of mortality.

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High prevalence of diabetes and other comorbidities in hospitalized patients with COVID-19 in Delhi, India, and their association with outcomes

Cited by 59 publications

References 23 publications

Predictors of critical illness and mortality based on symptoms and initial physical examination for patients with SARS-CoV-2: A retrospective cohort study

Predictors of critical illness and mortality based on symptoms and initial physical examination for patients with SARS-CoV-2: A retrospective cohort study

Short Communication: Coronavirus Disease 19 Among People Living with HIV in Western India: An Observational Cohort Study

Effect of plasma glucose at admission on COVID-19 mortality: experience from a tertiary hospital

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