Well-controlled vs poorly-controlled diabetes in patients with COVID-19: Are there any differences in outcomes and imaging findings?

Abstract

We aimed to compare the clinical outcomes and imaging findings between COVID-19 patients with well-controlled diabetes and those with poorly-controlled diabetes. Methods: In this retrospective single-center study, 117 patients with coexistent COVID-19 and type 2 diabetes mellitus were included. Patients were divided into two groups based on HbA1c values. Clinical data and laboratory parameters were collected from patients' medical records. Also, the chest computed tomography (CT) score was defined by the summation of individual scores from 5 lung lobes: scores of 0, 1, 2, 3, 4 and 5 were respectively assigned for each lobe if pulmonary involvement was 0%, less than 5%, 5%-25%, 26%-49%, 50%-75%, or more than 75% of each region. Results: Among all patients with diabetes, 93 (79.5%) patients had poorly-controlled diabetes and 24 (20.5%) had well-controlled diabetes; 66 (56.4%) patients were male and the median age was 66 years (IQR, 55-75 years). The chest CT severity scores were not significantly different between patients with well-controlled diabetes and those with poorly-controlled diabetes (p = 0.33). Also, the mortality and recovery rates were similar between the two groups (p = 0.54 and p = 0.85, respectively). Conclusion: Based on the results, clinical outcomes and chest CT severity scores are similar between patients with well-controlled and poorly-controlled diabetes among the Iranian population with COVID-19.

Prevalence, Risk Factors and Outcomes Associated with Acute Kidney Injury in Patients Hospitalized for COVID-19: A Comparative Study between Diabetic and Nondiabetic Patients

“…As mentioned earlier, our study showed that proteinuria was an independent risk factor for AKI development among patients with diabetes and COVID-19; this finding supports previous studies underlining the strict relationship between albumin excretion rate and cardiorenal outcomes in diabetic nephropathy [ 26 – 28 ]. Furthermore, while no association was previously found between HBA1c level and mortality in patients with coexistent diabetes and COVID-19 [ 29 , 30 ], this study showed that higher HBA1c levels put patients with diabetes at greater risk of developing AKI during hospital stay.…”

Diffuse alveolar damage and thrombotic microangiopathy are the main histopathological findings in lung tissue biopsy samples of COVID-19 patients

“…Previous studies have shown that severe cases of COVID-19 may develop acute respiratory distress syndrome (ARDS), multiple organ failure, and ultimately succumb to death [ 2 , 3 ]. Among patients with COVID-19, older individuals, male patients, and those with comorbidities are known to have higher morbidity and mortality rates [ 4 , 5 ][ 38 ]. Respiratory failure seems to be the main cause of death in infected patients [ 6 ]; identification of the exact mechanism of death, however, can only be achieved after performing pathologic examination on decedents.…”

Does glycemic control affect outcome of COVID‐19?

“…In an Iranian hospital, 24 persons with HbA1c 6.5-7 had a similar mortality rate (21%) to that of 93 persons (23%) with HbA1c 8%-11.2%. 4 In analysis of 1317 persons with diabetes hospitalized for COVID-19 in France, the outcome of tracheal intubation or death by day 7 was not associated with HbA1c level on admission, although there was a linear correlation with admission plasma glucose, as well as with body mass index. 5 Another study, of 1279 persons with diabetes hospitalized for COVID-19 in New York, showed no association of mortality with HbA1c on admission, whereas obesity, as well as increasing age and male sex and increasing complexity of outpatient diabetes treatment, were again associated with greater likelihood of adverse outcome.…”