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Published on: July 5, 2022
Differences in the Clinical and Hematological Characteristics of COVID-19 Patients with and without Type 2 Diabetes
Yujing Sun1,2,3, Ruxing Zhao1,2,3, Zhao Hu4
1Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
Insights
Type 2 diabetes (T2D) complicates COVID-19, increasing risks of diarrhea, bacterial infections, and prolonged pneumonia recovery. T2D patients exhibit distinct hematological changes, including higher white blood cell counts but more severe lymphocytopenia.
Area of Science:
- Infectious Diseases
- Endocrinology
- Hematology
Background:
- Coronavirus disease 2019 (COVID-19) is a global health crisis.
- Type 2 diabetes (T2D) is a common comorbidity with significant health implications.
Purpose of the Study:
- To investigate the impact of T2D comorbidity on the clinical and hematological profiles of COVID-19 patients.
- To identify specific differences in disease presentation and laboratory findings between COVID-19 patients with and without T2D.
Main Methods:
- Retrospective analysis of 164 hospitalized COVID-19 patients.
- Comparison of clinical, imaging, and laboratory data between 40 T2D patients and age/sex-matched controls.
- Detailed assessment of routine blood tests, serum biochemistry, and coagulation function upon admission.
Main Results:
- T2D patients experienced more diarrhea and prolonged pneumonia recovery, indicated by CT scans.
- Comorbidity with T2D increased the risk of secondary bacterial infections.
- T2D patients showed higher white blood cell and neutrophil counts, but also more severe lymphocytopenia and inflammation.
- Increased risk of hyperlactatemia, hyponatremia, and hypocalcemia observed in T2D patients.
Conclusions:
- COVID-19 patients with T2D exhibit unique clinical and hematological characteristics.
- A distinct clinical severity scoring system may be needed for COVID-19 patients with T2D.
- Findings offer insights for assessing and managing COVID-19 in individuals with T2D.
Objective:
To examine whether comorbidity with type 2 diabetes (T2D) affects the clinical and hematological parameters of coronavirus disease 2019 (COVID-19) patients.
Methods:
We retrospectively investigated the clinical, imaging, and laboratory characteristics of patients with confirmed COVID-19 who were hospitalized from January 30, 2020 to March 17, 2020, at the Renmin Hospital of Wuhan University. A detailed clinical record was kept for each subject, including the medical history of COVID-19 and physical and laboratory examinations. A total of 164 subjects were eligible for the study, among which 40 patients were comorbid with T2D. Further analysis was conducted in two subcohorts of sex- and age-matched patients with and without T2D to identify hematological and biochemical differences. The laboratory tests, including routine blood tests, serum biochemistry, and coagulation function, were performed upon admission.
Results:
The two groups showed no significant differences in baseline parameters, including age, sex, chest X-ray, or computed tomography (CT) findings, upon admission. However, patients with T2D showed an increased incidence of diarrhea. T2D patients required more recovery time from pneumonia, as shown by follow-up CT findings, which might contribute to the prolonged hospitalization. Comorbidity with T2D also increased risk of secondary bacterial infection during COVID-19. The T2D group had significantly higher white blood cell and neutrophil counts compared with the nondiabetic group, but T2D patients suffered from more severe lymphocytopenia and inflammation (P < 0.05). Most biochemical parameters showed no significant differences between the two groups (P > 0.05). However, patients with T2D seemed to have a significantly higher risk of developing hyperlactatemia, hyponatremia, and hypocalcemia.
Conclusions:
COVID-19 patients comorbid with T2D demonstrated distinguishing clinical features and hematological parameters during the infection. It is necessary to develop a different clinical severity scoring system for COVID-19 patients with T2D. This study may provide helpful clues for the assessment and management of COVID-19 in T2D patients.
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