Clinical presentation and mortality risk factors for COVID-19 among diabetic patients in a tertiary care center in South India

Marimuthu, Yamini; Kunnavil, Radhika; Satyanarana, N.; Anil, N.S.; Kumar, Jeetendra; Sharma, Nandini; Chopra, Kamal Kishore

BACKGROUND: Non-communicable diseases (NCD) like hypertension, diabetes, cardiovascular and cerebrovascular diseases are the most common comorbidities among COVID-19 patients. The clinical presentation and mortality pattern of COVID-19 are different for patients with comorbidities and without comorbidities. OBJECTIVE: To determine the clinical presentation of COVID-19 and risk factors for COVID-19 mortality among diabetic patients in a tertiary care hospital in South India. METHODS: A record-based longitudinal study was conducted by reviewing the case records of COVID-19 patients admitted for treatment from June 2020 to September 2020 in a tertiary care centre in South India. Potential risk factors for COVID-19 mortality were analysed using univariate binomial logistic regression, generalized linear models (GLM) with the Poisson distribution. Survival curves were made using the Kaplan-Meier method. RESULTS: Out of 200 COVID-19 patients with diabetes with a mean (SD) age of 56.1 (11.8) years, 61% were men. The median survival time was slightly lesser in male COVID-19 patients (15 days) as compared to female patients (16 days). The risk of mortality among COVID-19 patients with diabetes is increased for patients who presented with breathlessness (aRR=4.5 (95% CI: 2.3-8.8)), had positive history of smoking (aRR=1.9 (95% CI: 1.1-3.8)), who had CKD (aRR=1.8 (95% CI: 1.1-2.8)) and who had cardiac illness (aRR=1.6 (95% CI: 0.9-2.7)). CONCLUSION: Diabetes patients with COVID-19 need to be given additional care and monitoring especially if they present with breathlessness, positive history of smoking, cardiac illness and, CKD. Public health campaigns and health education activities to control smoking is needed to reduce the COVID-19 mortality in diabetes patients.