The Effect of Diabetes Mellitus and Glycemic Parameters on the Prognosis of COVID-19 Disease

Abstract

Studies show that coronavirus disease 2019 (COVID-19) is more severe in people with diabetes. Although diabetes has been shown to be a risk factor for severe COVID-19 disease, the relationship between fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c) with mortality and prognosis in COVID-19 is still controversial. We designed this study to investigate the impact of diabetes on the prognosis of COVID-19 and to show the relationship between FBG and HbA1c and COVID-19 mortality. In this study, patients with COVID-19 who were hospitalized in the COVID-19 Ward of the Department of Chest Diseases and Intensive Care Unit of Antalya Research and Training Hospital between December 2019 and December 2021 were included. The patients’ demographic data, treatment and laboratory results, developing complications, and clinical outcomes were extracted from their electronic medical records. The mortality of patients with diabetes was significantly higher than that of patients without diabetes (p : 0.0001). The duration of hospitalization, the development of complications, and the need for oxygen, antibiotics, and steroids were higher in patients with diabetes than in patients without diabetes (p : 0.0001). C-reactive protein, erythrocyte sedimentation rate, and fibrinogen, which are associated with poor prognosis in studies, were higher in patients with diabetes (p : 0.0001). When comparing discharged and deceased patients with diabetes, HbA1c was higher in discharged patients and FBG was higher in deceased patients (p : 0.003 and p : 0.030, respectively). Our study confirms the finding that COVID-19 patients with diabetes have a poor prognosis and mortality. It also shows that FBG level is related to COVID-19 mortality. Contrary to some studies, the low detection of HbA1c in deceased patients may indicate that initial blood glucose rather than glycemic control prior to infection, is associated with COVID-19 mortality. The influence of HbA1c and FBG on COVID-19 prognosis could be investigated in larger studies.