Investigation of Risk Factors for Hospitalization of COVID-19 Patients with Diabetes in Najaf, Iraq

Document Type : Original Articles

Authors

1 Department of Clinical and Laboratory Sciences‏, Faculty of Pharmacy, University of Kufa, Najaf, Iraq

2 Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Kufa, Najaf, Iraq

Abstract

Preliminary findings indicate that patients with diabetes mellitus (DM) are at additional risk of infecting with COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is associated with increased mortality in these patients. Hyperglycemia can affect inflammatory and immune responses, which leads patients to severe COVID-19 consequences. The present study investigated risk factors for hospitalized COVID-19 patients with DM in Najaf, Iraq. 127 patients with positive PCR tests were selected from Al-Hakeem Hospital and Al-Sadr Teaching Hospital. Demographic characteristics and laboratory data were collected to compare patients with and without DM. Chi-squared test followed by odds ratio calculations were used to investigate the risk factors associated with hospitalization of COVID-19 patients with or without DM in the ICU and RCU. Analysis of the relationship between risk factors indicated that age above 65 years, high BMI, hypertension, respiratory rate> 24 BPM, CVD, blood sugar> 180 mg/dl, D-dimer> 1000, ALT> 50 and AST> 40 U/L were independent risk factors for hospitalized COVID-19 patients with DM (P≤0.05). Therefore, investigating these factors may detect the risk of infection with COVID-19 in patients with DM in advance. Physicians should further consider risk factors to discover a targeted intervention to improve clinical efficacy.

Keywords

Main Subjects

References

  1. Silveira L, Guerreiro GP, Lisboa LAF, Mejía OAV, Dallan LRP, Dallan LAO, et al. Coronary Artery Bypass Graft During the COVID-19 Pandemic. Braz J Cardiovasc Surg. 2020;35(6):1003-6
  2. Yang X, Yu Y, Xu J, Shu H, Xia Ja, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475-81.
  3. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62.
  4. Korbel L, Spencer JD. Diabetes mellitus and infection: an evaluation of hospital utilization and management costs in the United States. J Diabetes Complications. 2015;29(2):192-5.
  5. Zhang Q, Bastard P, Liu Z, Le Pen J, Moncada-Velez M, Chen J, et al. Inborn errors of type I IFN immunity in patients with life-threatening COVID-19. Science. 2020;370(6515).
  6. Singh AK, Gupta R, Ghosh A, Misra A. Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations. Diabetes Metab Syndr. 2020;14(4):303-10.
  7. Al-Salameh A, Lanoix JP, Bennis Y, Andrejak C, Brochot E, Deschasse G, et al. Characteristics and outcomes of COVID-19 in hospitalized patients with and without diabetes. Diabetes Metab Res Rev. 2021;37(3): 3388.
  8. Li K, Zhang C, Qin L, Zang C, Li A, Sun J, et al. A Nomogram Prediction of Length of Hospital Stay in Patients with COVID-19 Pneumonia: A Retrospective Cohort Study. Dis Markers. 2021;2021:5598824.
  9. Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020;71(15):762-8.
  10. Liu Z, Bai X, Han X, Jiang W, Qiu L, Chen S, et al. The association of diabetes and the prognosis of COVID-19 patients: A retrospective study. Diabetes Res Clin Pract. 2020;169:108386.
  11. Lei M, Lin K, Pi Y, Huang X, Fan L, Huang J, et al. Clinical Features and Risk Factors of ICU Admission for COVID-19 Patients with Diabetes. J Diabetes Res. 2020;2020:5237840.
  12. Singh AK, Singh R. Hyperglycemia without diabetes and new-onset diabetes are both associated with poorer outcomes in COVID-19. Diabetes Res Clin Pract. 2020;167:108382.
  13. Zhu L, She ZG, Cheng X, Qin JJ, Zhang XJ, Cai J, et al. Association of Blood Glucose Control and Outcomes in Patients with COVID-19 and Pre-existing Type 2 Diabetes. Cell Metab. 2020;31(6): 1068-1077.
  14. Bornstein SR, Dalan R, Hopkins D, Mingrone G, Boehm BO. Endocrine and metabolic link to coronavirus infection. Nat Rev Endocrinol. 2020;16(6):297-8.
  15. Li MY, Li L, Zhang Y, Wang XS. Expression of the SARS-CoV-2 cell receptor gene ACE2 in a wide variety of human tissues. Infect Dis Poverty. 2020;9(1):45.
  16. Sardu C, D'Onofrio N, Balestrieri ML, Barbieri M, Rizzo MR, Messina V, et al. Outcomes in Patients With Hyperglycemia Affected by COVID-19: Can We Do More on Glycemic Control? Diabetes Care. 2020;43(7):1408-15.
  17. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
  18. Wang M, Yan W, Qi W, Wu D, Zhu L, Li W, et al. Clinical characteristics and risk factors of liver injury in COVID-19: a retrospective cohort study from Wuhan, China. Hepatol Int. 2020;14(5):723-32.
  19. Zhang C, Shi L, Wang F-S. Liver injury in COVID-19: management and challenges. Lancet Gastroenterol. Hepatol. 2020;5(5):428-30.
  20. Zhang L, Yan X, Fan Q, Liu H, Liu X, Liu Z, et al. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost. 2020;18(6):1324-9.
  21. Gupta N, Zhao YY, Evans CE. The stimulation of thrombosis by hypoxia. Thromb Res. 2019;181:77-83.
  22. Giovannelli J, Trouiller P, Hulo S, Cherot-Kornobis N, Ciuchete A, Edme JL, et al. Low-grade systemic inflammation: a partial mediator of the relationship between diabetes and lung function. Ann Epidemiol. 2018;28(1):26-32.
  23. Chen H, Liu C, Cheng C, Zheng L, Huang K. Effects of Apelin Peptides on Diabetic Complications. Curr Protein Pept Sci. 2018;19(2):179-89.
  24. Kumar V, Kanakasabapathi R, S.Mahalakshmi, Kandasamy M. Comparison of Inflammatory Markers and Lung Involvement Between Diabetic And Non Diabetic Covid-19 Patients. J Med Dent Sci. 2021; 20: 1-6.
  25. Sandooja R, Vura N, Morocco M. Heightened ACE Activity and Unfavorable Consequences in COVID-19 Diabetic Subjects. Int J Endocrinol. 2020;2020:7847526.
  1. Chakrabarti SS, Kaur U, Banerjee A, Ganguly U, Banerjee T, Saha S, et al. COVID-19 in India: Are Biological and Environmental Factors Helping to Stem the Incidence and Severity? Aging Dis.2020;2020: 7847526.
  2. Mbengue A, Diaw M, Coly MS, Sow,, A.K. F, S.H. B, F., , SAR F, et al. Evaluation of the ventilatory function of Senegalese patients with type 2 diabetes. J Physiol Pathophysiol. 2019 10(2):34-41.
Archives of Razi Institute
Volume 77, Issue 5 - Serial Number 5
September and October 2022
Pages 1639-1645

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