Study of Clinical Features, Laboratory and Radiological Findings, Morbidity, and Mortality in COVID-19 Patients with Controlled and Uncontrolled Diabetes Mellitus

Abstract

Introduction: Coronavirus disease 19 (COVID-19) is a pandemic caused by a novel coronavirus, the Severe Acute Respiratory Syndrome Coronavirus 2. Diabetes and its complications are major causes of morbidity and mortality. Patients with uncontrolled diabetes may be associated with poorer outcomes as compared with patients with good glycemic control. Methodology: A total of 120 patients with type 2 diabetes mellitus with COVID-19 were taken from a tertiary care center in Pune, Maharashtra, and included in the study following their voluntary informed consent. Results: It was observed that patients with poor glycemic control had a greater prevalence of symptoms including fever (64.9% vs 55.4%), cough (51.3% vs 42.2%), and dyspnoea (40.5% vs 27.7%). C-reactive protein (9.40 vs 5.66), D-dimer (668.2 vs 457.9), and ferritin levels (352 vs 238) were observed to be greater in patients with poor glycemic control. Chest X-Ray changes (45.9% vs 17.2%) and CT severity score (9.32 vs 5.79) were significantly greater in patients with poor glycemic control. Patients with poor glycemic control also had an increased incidence of O2 requirement, increased mortality, and a longer duration of hospital stay. Poor glycemic control was also associated with an increased incidence of complications like acute respiratory distress syndrome (35.1% vs 18.0%), sepsis with or without septic shock (18.9% vs 9.6%), acute coronary syndrome (13.5% vs 8.4%), acute kidney injury (18.9% vs 3.6%), acute hepatic injury (13.5% vs 2.4%), and other complications like diabetic ketoacidosis, pulmonary thromboembolism, and cerebrovascular accident (10.8% vs 6.0%). Conclusion: On the basis of our findings, we concluded that patients with poor glycemic control were associated with poorer outcomes and increased complications.