Unexpectedly lower mortality rates in COVID-19 patients with and without type 2 diabetes in Istanbul

Satman, Ilhan; Demirci, Ibrahim; Haymana, Cem; Tasci, Ilker; Salman, Serpil; Ata, Naim; Dagdelen, Selcuk; Sahin, Ibrahim; Emral, Rifat; Cakal, Erman; Atmaca, Aysegul; Sahin, Mustafa; Celik, Osman; Demir, Tevfik; Ertugrul, Derun; Unluturk, Ugur; Yalcin Arga, Kazim; Caglayan, Murat; Sonmez, Alper

AIMS: Type 2 diabetes mellitus (T2DM) is a risk factor for severe COVID-19. Our aim was to compare the clinical outcomes of patients with and without T2DM during the first hit of COVID-19 in Istanbul METHODS: A retrospective population-based study was conducted including all consecutive adult symptomatic COVID-19 cases. Patients were confirmed with rt-PCR; treated and monitored in accordance with standard protocols. The primary endpoints were hospitalization and 30-day mortality RESULTS: Of the 93,571 patients, 22.6% had T2DM, with older age and higher BMI. Propensity Score matched evaluation resulted in significantly higher rates of hospitalization (1.5-fold), 30-day mortality (1.6-fold), and pneumonia (1.4-fold). They revealed more severe laboratory deviations, comorbidities, and frequent drug usage than the Non-DM group. In T2DM age, pneumonia, hypertension, obesity, and insulin-based therapies were associated with an increased likelihood of hospitalization; whereas age, male gender, lymphopenia, obesity, and insulin treatment were considerably associated with higher odds of death CONCLUSIONS: COVID-19 patients with T2DM had worse clinical outcomes with higher hospitalization and 30-day mortality rates than those without diabetes. Compared to most territories of the world, COVID-19 mortality was much lower in Istanbul, which may be associated with accessible healthcare provision and the younger structure of the population