What Impact Does Glycemic Control Have on the Final Outcome of Diabetic Patients with Severe COVID-19?

Background: Diabetes represents one of the most frequently reported comorbidities in patients with COVID-19 disease; and is a risk factor for disease progression, and death. Aim: Assessing the impact of glycemic control on the progression of Covid-19 disease. Materials and methods: This is a mixed cohort study, from November 2020 to November 2021, with 369 diabetic patients hospitalized for covid-19, at the Duc De Tovar hospital in Tangier. With a follow-up at D7, D14, D21, D28, and the thirtieth day after hospital discharge. Results: We objectified a male predominance (61.5%), the average age being 60-years-old (+/-11.25; (18-85)). 126 diabetic patients were admitted to the reanimation unit (34.1%), and 243 to the intensive care unit (65.9%).190 patients had satisfactory glycemic control (51.5%), and glycemic targets were not reached in 179 patients (48.5%). Unfavorable progression was defined by in-hospital mortality, which was our primary judgment criterion. Thus, 162 patients died in the 2 admission units (43.9%), including 67 patients in the intensive care unit (41%) and 95 patients in the reanimation unit (59%). The unfavorable progression of the Covid-19 disease was not significantly related to the glycemic control during hospitalization, but significantly related to the respiratory distress syndrome (p = 0.030), to the transfer to reanimation unit (p = 0.004), to the invasive ventilation (p = 0.026), after multivariate analysis. Conclusion: According to the results of our study, glycemic control plays a modifying role on the effect of other factors aggravating the progression of Covid-19.