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COVID-19 Case Management Outcomes Amongst Diabetes and Hypertensive Patients in the United Arab Emirates: A
Aysha Alkhemeiri1, Shaikha Al Zaabi2, Jeyaseelan Lakshmanan3
1Department of Medicine, Tawam Hospital, Abu Dhabi P.O. Box 15258, United Arab Emirates.
Insights
COVID-19 significantly worsens outcomes for patients with diabetes, increasing risks of severe illness, hyperglycemia, and death. The study also found that 9.8% of COVID-19 patients developed new-onset diabetes.
Area of Science:
- Endocrinology
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic presented unique challenges for patients with comorbid conditions, particularly diabetes.
- Diabetes mellitus increases the risk of severe COVID-19 outcomes due to multisystemic effects and glucose dysregulation.
Purpose of the Study:
- To investigate the prevalence of diabetes among hospitalized COVID-19 patients in the UAE.
- To compare the clinical characteristics and outcomes of COVID-19 patients with and without pre-existing diabetes.
- To identify predictors of mortality in COVID-19 patients with diabetes.
Main Methods:
- A prospective study involving 1199 adult patients admitted with confirmed COVID-19 between December 2020 and April 2021 in the UAE.
- Comparison of demographics, clinical features, and outcomes between diabetic and non-diabetic COVID-19 patients.
- Analysis of endpoints including new-onset diabetes, intensive care unit (ICU) admission, need for non-invasive ventilation (NIV), intubation, and mortality.
Main Results:
- Diabetes prevalence was 9.8% among hospitalized COVID-19 patients. Diabetic patients exhibited higher rates of ICU admission (11.1% vs. 7.1%), NIV requirement (9.6% vs. 6.4%), and intubation (5.45% vs. 2%).
- Nearly three-fourths (73.4%) of diabetic patients experienced worsened hyperglycemia compared to 20.9% of non-diabetic patients. New-onset diabetes was identified in 9.8% of COVID-19 patients.
- Advanced age, diabetes, and hypertension were significant predictors of mortality in COVID-19 patients. Pre-existing hypertension independently predicted increased COVID-19 severity and death.
Conclusions:
- COVID-19 severity is significantly higher in patients with diabetes, associated with worsening hyperglycemia and poorer clinical outcomes.
- Diabetes and hypertension are critical risk factors for mortality in COVID-19 patients.
- The findings highlight the vulnerability of diabetic populations during the COVID-19 pandemic and the importance of managing comorbid conditions.
Abstract:
The global pandemic of the novel Coronavirus infection 2019 (COVID-19) challenged the care of comorbid patients. The risk imposed by COVID-19 on diabetes patients is multisystemic, exponential, and involves glucose dysregulation. The increased burden for diabetes patients infected with COVID-19 is substantial in countries with a high prevalence of diabetics, such as the United Arab Emirates (UAE). This study aims to explore the prevalence of diabetes, clinical characteristic, and outcomes of patients admitted for COVID-19 treatment with or without a concurrent preadmission diagnosis of diabetes. A prospective study was performed on 1199 adults admitted with confirmed COVID-19 from December 2020 to April 2021 to a single hospital in the UAE. The study compared the demographics, clinical characteristics, and outcomes in COVID-19-infected patients with diabetes to patients without diabetes. The study endpoints include the development of new-onset diabetes, admission to ICU, trends in the blood glucose levels, and death. A total of 1199 patients (390 with diabetes) were included in the study. A diabetes prevalence was detected among 9.8% of the study population. Among the diabetes group, 10.8% were morbidly obese, 65.4% had associated hypertension, and 18.9% had coronary artery disease. Diabetes patients showed higher rates of ICU admission (11.1% vs. 7.1%), NIV requirement (9.6% vs. 6.4%), and intubation (5.45% vs. 2%) compared to the non-diabetes group. Advanced age was a predictor of a worsening COVID-19 course, while diabetes (p < 0.050) and hypertension (p < 0.025) were significant predictors of death from COVID-19. Nearly three-fourths (284 (73.4%)) of the diabetic patients developed worsened hyperglycemia as compared to one-fifth (171 (20.9%)) of the nondiabetic patients. New-onset diabetes was detected in 9.8% of COVID-19 patients. COVID-19 severity is higher in the presence of diabetes and is associated with worsening hyperglycemia and poor clinical outcomes. Preexisting hypertension is a predictor of COVID-19 severity and death.
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