Correlation between COVID-19 Disease Severity and its Outcome in Diabetes Mellitus Patients

  • Sanjit Kumar Postgraduate Resident, Department of Medicine, Maulana Azad Medical College and Lok Nayak hospital, New Delhi, India
  • Sandeep Garg Director Professor, Department of Medicine, Maulana Azad Medical College and Lok Nayak hospital, New Delhi, India.
  • Sunita Aggarwal Director Professor, Department of Medicine, Maulana Azad Medical College and Lok Nayak hospital, New Delhi, India
  • Harpreet Singh Associate Professor, Department of Medicine, Maulana Azad Medical College and Lok Nayak hospital, New Delhi, India
  • Khyati Postgraduate Resident, Department of Microbiology, Maulana Azad Medical College and Lok Nayak hospital, New Delhi, India
  • Sricharan Vijayakumar Postgraduate Resident, Department of Medicine, Maulana Azad Medical College and Lok Nayak hospital, New Delhi, India
Keywords: SARS-CoV-2, News, HbA1C, RT-PCR Cycle Threshold Value

Abstract

Introduction: Diabetes mellitus is a common metabolic disorder that contributes a significant burden on the healthcare system. It is one of the major comorbidities associated with COVID-19 and affects its severity.

Aim: To study the correlation between COVID-19 disease severity and its outcome in diabetes mellitus patients and to correlate HbA1C with COVID-19 disease severity, NEWS, Ct RT-PCR value and clinical outcome in COVID-19 diabetic patients.

Settings and Design: This was a prospective cross-sectional observational study conducted in the Department of Medicine, Maulana Azad Medical College.

Method and Material: The study included a total of 60 subjects 30 in the diabetic group and 30 in the non-diabetic group. NEWS was calculated on the day of admission. HbA1C was correlated with disease severity,
NEWS, Ct RT-PCR value and clinical outcome of patients. The data gathered were processed by SPSS version 25. The correlation between HbA1C, disease severity, NEWS, and Ct RT-PCR value was determined using Pearson correlation coefficient.

Results: Diabetic patients have more severe COVID-19 disease. NEWS at admission was higher in these patients. Higher HbA1C is associated with severe disease. HbA1C positively correlates with NEWS but negatively correlates with Ct RT-PCR value. Incidences of organ injury and inflammatory markers were higher in diabetic patients. Diabetes was associated with more complications and worse outcomes.

Conclusions: Diabetic patients are more susceptible to the development of severe and worse outcomes in COVID.

How to cite this article:
Kumar S, Garg S, Aggarwal S, Singh H, Khyati, Vijayakumar S. Correlation between COVID-19 Disease Severity and its Outcome in Diabetes Mellitus Patients. J Adv Res Med. 2022;9(2):1-8.

DOI: https://doi.org/10.24321/2349.7181.202206

References

Drosten C, Günther S, Preiser W, van der Werf S, Brodt HR, Becker S, Rabenau H, Panning M, Kolesnikova L,

Fouchier RA, Berger A, Burguière AM, Cinatl J, Eickmann M, Escriou N, Grywna K, Kramme S, Manuguerra JC,

Müller S, Rickerts V, Stürmer M, Vieth S, Klenk HD, Osterhaus AD, Schmitz H, Doerr HW. Identification

of a novel coronavirus in patients with severe acute respiratory syndrome. N Engl J Med. 2003;348(20):1967-

[PubMed] [Google Scholar]

Fielding BC. Human coronavirus NL63: a clinically important virus? Future Microbiol. 2011;6(2):153-9.

[PubMed] [Google Scholar]

Muller LM, Gorter KJ, Hak E, Goudzwaard WL, Schellevis FG, Hoepelman AI, Rutten GE. Increased risk of common infections in patients with type 1 and type 2 diabetes mellitus. Clin Infect Dis. 2005;41(3):281-8. [PubMed] [Google Scholar]

Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, Ji R, Wang H, Wang Y, Zhou Y. Prevalence of comorbidities

and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis.

;94:91-5. [PubMed] [Google Scholar]

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DS, Du B, Li LJ, Zeng G, Yuen KY, Chen RC, Tang CL, Wang T, Chen PY, Xiang J, Li SY, Wang JL, Liang ZJ, Peng YX, Wei L, Liu Y, Hu YH, Peng P, Wang JM, Liu

JY, Chen Z, Li G, Zheng ZJ, Qiu SQ, Luo J, Ye CJ, Zhu SY, Zhong NS; China Medical Treatment Expert Group for

Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.

[PubMed] [Google Scholar]

Clinical Management Protocol: COVID-19. Ministry of Health & Family Welfare, Government of India Directorate General of Health Services (EMR division). https://www.mohfw.gov.in/pdf/

ClinicalManagementProtocolforCOVID19. Accessed June 27,2020.

Royal College of Physicians. National Early Warning Score (NEWS) standardising the assessment of acuteillness severity in the NHS. Report of a working party. London: RCP; 2012.

Smith GB, Prytherch DR, Meredith P, Schmidt PE, Featherstone PI. The ability of the National Early

Warning Score (NEWS) to discriminate patients at risk of early cardiac arrest, unanticipated intensive

care unit admission, and death. Resuscitation. 2013 Apr;84(4):465-70. [PubMed] [Google Scholar]

Shah BR, Hux JE. Quantifying the risk of infectious diseases for people with diabetes. Diabetes Care.2003;26(2):510-3. [PubMed] [Google Scholar]

Wu J, Zhang J, Sun X, Wang L, Xu Y, Zhang Y, Liu X, Dong C. Influence of diabetes mellitus on the severity and

fatality of SARS-CoV-2 (COVID-19) infection. Diabetes Obes Metab. 2020;22(10):1907-14. [PubMed] [Google

Scholar]

Zhang Y, Li H, Zhang J, Cao Y, Zhao X, Yu N, Gao Y, Ma J, Zhang H, Zhang J, Guo X, Liu X. The clinical characteristics and outcomes of patients with diabetes and secondary

hyperglycaemia with coronavirus disease 2019: a singlecentre, retrospective, observational study in Wuhan.

Diabetes Obes Metab. 2020;22(8):1443-54. [PubMed] [Google Scholar]

Chung SM, Lee YY, Ha E, Yoon JS, Won KC, Lee HW, Hur J, Hong KS, Jang JG, Jin HJ, Choi EY, Shin KC, Chung

JH, Lee KH, Ahn JH, Moon JS. The risk of diabetes on clinical outcomes in patients with coronavirus disease

: a retrospective cohort study. Diabetes Metab J. 2020;44(3):405-13. [PubMed]

Hamming I, Timens W, Bulthuis ML, Lely AT, Navis GJ, van Goor H. Tissue distribution of ACE2 protein,

the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol.

;203(2):631-7. [PubMed] [Google Scholar]

Roca-Ho H, Riera M, Palau V, Pascual J, Soler MJ. Characterization of ACE and ACE2 expression within

different organs of the NOD mouse. Int J Mol Sci. 2017;18(3):563. [PubMed] [Google Scholar]

Yan Y, Yang Y, Wang F, Ren H, Zhang S, Shi X, Yu X, Dong K. Clinical characteristics and outcomes of patients with severe covid-19 with diabetes. BMJ Open Diabetes Res Care. 2020;8(1):e001343. [PubMed] [Google Scholar]

Ren H, Yang Y, Wang F, Yan Y, Shi X, Dong K, Yu X, Zhang S. Association of the insulin resistance marker TyG index with the severity and mortality of COVID-19. Cardiovasc Diabetol. 2020;19(1):58. [PubMed] [Google Scholar]

Mithal A, Jevalikar G, Sharma R, Singh A, Farooqui KJ, Mahendru S, Krishnamurthy A, Dewan A, Budhiraja S.

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

and their association with outcomes. Diabetes Metab Syndr. 2021;15(1):169-75. [PubMed] [Google Scholar]

Wang Z, Du Z, Zhu F. Glycosylated hemoglobin is associated with systemic inflammation,

hypercoagulability, and prognosis of COVID-19 patients. Diabetes Res Clin Pract. 2020;164:108214.

[PubMed] [Google Scholar]

Yu X, Sun S, Shi Y, Wang H, Zhao R, Sheng J. SARS-CoV-2 viral load in sputum correlates with risk of COVID-19

progression. Crit Care. 2020;24:170. [PubMed] [Google Scholar]

Rajyalakshmi B, Samavedam S, Reddy PR, Aluru N. Prognostic value of “cycle threshold” in confirmed

COVID-19 patients. Indian J Crit Care Med. 2021;25(3):322-6. [PubMed] [Google Scholar]

Magleby R, Westblade LF, Trzebucki A, Simon MS, Rajan M, Park J, Goyal P, Safford MM, Satlin MJ. Impact of

Severe Acute Respiratory Syndrome Coronavirus 2 viral load on risk of intubation and mortality among

hospitalized patients with Coronavirus Disease 2019. Clin Infect Dis. 2021;73(11):e4197-205. [PubMed]

[Google Scholar

Published
2022-09-09