The association of diabetes and the prognosis of COVID-19 patients: a retrospective study

Liu, Zhelong; Bai, Xi; Han, Xia; Jiang, Wangyan; Qiu, Lin; Chen, Shi; Yu, Xuefeng

Abstract Aims This study evaluated the impact of previous glycemic control and in-hospital use of antidiabetic/antihypertensive drugs on the prognosis of COVID-19 patients with diabetes. Methods In this retrospective cohort study, consecutive inpatients with laboratory confirmed COVID-19 were enrolled from Tongji Hospital (Wuhan, China). Patients without diabetes were matched to those with diabetes based on age, sex, and comorbidities. All patients were followed up to a clinical endpoint (discharge, worsening including transferring to ICU or immediate death). Data and outcomes were extracted from medical records and analyzed. Results 64 patients with pre-existing diabetes were included in this study, with 128 matched patients without diabetes included as a control group. Patients with diabetes had a higher rate of worsening (18.8% versus 7.8%, p=0.025). Multivariable regression showed increased odds of worsening associated with previous glycemic control reflected by HbA1c (odds ratio 3.29, 95% CI 1.19-9.13, p=0.022) and receiver-operating characteristics (ROC) curve identified HbA1c of 8.6% (70 mmol/mol) as the optimal cut-off value. Univariate analysis demonstrated the in-hospital use of antidiabetic/antihypertensive drugs were not associated with a higher risk of worsening. Conclusions COVID-19 patients with diabetes had a higher risk of worsening, especially those with poorly-controlled HbA1c, with an optimal cut-off value of 8.6%. The in-hospital use of antidiabetic/antihypertensive drugs were not associated with increased odds of worsening in patients with diabetes.