Mortality Rate and Predictors of Mortality in Hospitalized COVID-19 Patients with Diabetes

Abstract

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.

Lymphopenia as a Biological Predictor of Outcomes in COVID-19 Patients: A Nationwide Cohort Study

“…Previous data from two Korean dedicated centers for COVID-19 revealed 17.9% lymphopenia in a total of 352 patients: The proportion of lymphopenia among the patients is comparable to that of our cohort. As far as we know, there have been four cohort studies that explored both the mortality rate of COVID-19 of entire subject in their cohort and a proportion of lymphopenia, as defined by ALC < 1000/mm 3 , identical to that in our study ( Table S2 ) [ 17 , 25 , 27 , 28 ] Interestingly, the order of mortality for each evaluation was consistent with that of a proportion of lymphopenia. These results could illustrate that mild lymphopenia, defined as ALC < 1000/mm 3 , could be a feasible biomarker to predict mortality of COVID-19.…”

Impact of diabetes mellitus on in-hospital mortality in adult patients with COVID-19: a systematic review and meta-analysis

“…Fourteen studies reported the outcome of mortality, and seven studies reported the outcome of length of hospital stay. Of the 19 studies, 10 studies were performed in China [ 18 , 20 – 22 , 24 , 26 – 31 ], two in USA [ 17 , 23 ], two in France [ 13 , 14 ], two in Korea [ 12 , 19 ], one in each of the following countries: UK [ 16 ], Qatar [ 25 ], and South Korea [ 15 ]. Detailed characteristics of the patients included in the meta-analysis are presented in Supplementary Digital File.…”

“…Fourteen studies reported in-hospital mortality [ 12 , 13 , 15 – 19 , 21 , 22 , 24 , 25 , 28 – 30 ]. The mortality of DM vs non-DM patients was 21.3 versus 6.1%, respectively (OR = 2.39; 95%CI: 1.65, 3.46; I 2 = 62%; P < 0.001; Fig.…”

Clinical characteristics and outcomes of COVID-19 infected diabetic patients admitted in ICUs of the southern region of Bangladesh

“…A recent study on Chinese patients reported that 14% of the COVID-19 patients who survived had diabetes as associated comorbidity, however 31% of those did not survive [ 21 ]. Likewise, the mortality rate was much higher among Korean COVID-19 patients with diabetes compared to those without (20.0% vs. 4.8%) [ 25 ]. Therefore, like other countries, Bangladeshi diabetic patients are more likely to have worse complications if they get infected with SARS-CoV-2.…”