Clinical Characteristics and Outcomes of Type 2 Diabetes Patients Infected with COVID-19: A Retrospective Study

Yingyu Chen; Jiankun Chen; Xiao Gong; Xianglu Rong; Dewei Ye; Yinghua Jin; Zhongde Zhang; Jiqiang Li; Jiao Guo

doi:10.1016/j.eng.2020.05.017

Clinical Characteristics and Outcomes of Type 2 Diabetes Patients Infected with COVID-19: A Retrospective Study

Engineering (Beijing). 2020 Oct;6(10):1170-1177. doi: 10.1016/j.eng.2020.05.017. Epub 2020 Jun 27.

Authors

Yingyu Chen^{1

2}, Jiankun Chen^{3

4}, Xiao Gong⁵, Xianglu Rong², Dewei Ye², Yinghua Jin^{1

2}, Zhongde Zhang^{3

4}, Jiqiang Li^{3

4}, Jiao Guo^{1

2}

Affiliations

¹ The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510080, China.
² Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine & Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education of the People's Republic of China & Key Unit of Modulating Liver to Treat Hyperlipemia SATCM & Guangdong TCM Key Laboratory for Metabolic Diseases, Guangdong Pharmaceutical University, Guangzhou 510006, China.
³ The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510120, China.
⁴ The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou 510120, China.
⁵ School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510006, China.

Abstract

Diabetes and its related metabolic disorders have been reported as the leading comorbidities in patients with coronavirus disease 2019 (COVID-19). This clinical study aims to investigate the clinical features, radiographic and laboratory tests, complications, treatments, and clinical outcomes in COVID-19 patients with or without diabetes. This retrospective study included 208 hospitalized patients (≥ 45 years old) with laboratory-confirmed COVID-19 during the period between 12 January and 25 March 2020. Information from the medical record, including clinical features, radiographic and laboratory tests, complications, treatments, and clinical outcomes, were extracted for the analysis. 96 (46.2%) patients had comorbidity with type 2 diabetes. In COVID-19 patients with type 2 diabetes, the coexistence of hypertension (58.3% vs 31.2%), coronary heart disease (17.1% vs 8.0%), and chronic kidney diseases (6.2% vs 0%) was significantly higher than in COVID-19 patients without type 2 diabetes. The frequency and degree of abnormalities in computed tomography (CT) chest scans in COVID-19 patients with type 2 diabetes were markedly increased, including ground-glass opacity (85.6% vs 64.9%, P < 0.001) and bilateral patchy shadowing (76.7% vs 37.8%, P < 0.001). In addition, the levels of blood glucose (7.23 mmol·L^-1 (interquartile range (IQR): 5.80-9.29) vs 5.46 mmol·L^-1 (IQR: 5.00-6.46)), blood low-density lipoprotein cholesterol (LDL-C) (2.21 mmol·L^-1 (IQR: 1.67-2.76) vs 1.75 mmol·L^-1 (IQR: 1.27-2.01)), and systolic pressure (130 mmHg (IQR: 120-142) vs 122 mmHg (IQR: 110-137)) (1 mmHg = 133.3 Pa) in COVID-19 patients with diabetes were significantly higher than in patients without diabetes (P < 0.001). The coexistence of type 2 diabetes and other metabolic disorders is common in patients with COVID-19, which may potentiate the morbidity and aggravate COVID-19 progression. Optimal management of the metabolic hemostasis of glucose and lipids is the key to ensuring better clinical outcomes. Increased clinical vigilance is warranted for COVID-19 patients with diabetes and other metabolic diseases that are fundamental and chronic conditions.

Keywords: COVID-19; Clinical characteristics; Comorbidities; Coronavirus disease; Diabetes.