4.4 Article

Poor prognosis indicators of type-2 diabetic COVID-19 patients

Journal

Publisher

ASSOC BRAS DIVULG CIENTIFICA
DOI: 10.1590/1414-431X2022e11819

Keywords

SARS-CoV-2; C-reactive protein; Lactate; Urea; D-dimer; NEWS

Funding

  1. Sao Paulo State Research Foundation (FAPESP) [2018/09868-7, 2018/07283-1, 2019/25892-8, 2020/04738-8, 2021/002 00-6, 2021/08624-0]
  2. Coordination for the Improvement of Higher-Level Personnel (CAPES) [88881.068515/201401]
  3. National Council for Scientific and Technological Development (CNPq)
  4. Pro-Rectory of Post-Graduate and Research of the Cruzeiro do Sul and Cidade de Sao Paulo Universities
  5. Hospital das Clinicas, University of Sao Paulo

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Diabetes is associated with a poorer prognosis in COVID-19 patients, with increased ICU admission rate, mechanical ventilation rate, vasopressor use, and longer treatment times. Diabetic patients with COVID-19 have higher plasma glucose, lactate, age, urea, NEWS, and D-dimer levels, indicating worse prognosis and outcomes. The NEWS score is a more accurate indicator for assessing the severity of COVID-19 in diabetic patients.
Diabetes is associated with a worse prognosis and a high risk of morbidity and mortality in COVID-19 patients. We aimed to evaluate the main factors involved in the poor prognosis in diabetic patients. A total of 984 patients diagnosed with COVID-19 admitted to the hospital were included in this study. Patients were first divided into type-2 diabetic (DM + ) and non-diabetic (DM-) groups. The participants were analyzed based on the National Early Warning Score (NEWS) and on the Quick-Sequential Organ Failure Assessment (qSOFA) to find the best prognostic risk score for our study. The DM + and DM- groups were divided into non-severe and severe groups. Comparative and correlative analyses were used to identify the physiological parameters that could be employed for creating a potential risk indicator for DM + COVID-19 patients. We found a poorer prognosis for the DM + COVID-19 patients with a higher ICU admission rate, mechanical ventilation rate, vasopressor use, dialysis, and longer treatment times compared with the DM- group. DM + COVID-19 patients had increased plasma glucose, lactate, age, urea, NEWS, and D-dimer levels, herein referred to as the GLAUND set, and worse prognosis and outcomes when compared with infected DM- patients. The NEWS score was a better indicator for assessing COVID-19 severity in diabetic patients than the q-SOFA score. In conclusion, diabetic COVID-19 patients should be assessed with the NEWS score and GLAUND set for determining their prognosis COVID-19 prognosis.

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