Clinical Characteristics and Outcomes of COVID-19 patients with diabetes mellitus in Kuwait

Background COVID-19 has a highly variable clinical presentation, ranging from asymptomatic to severe respiratory symptoms and death. Diabetes seems to be one of the main comorbidities contributing to a worse COVID-19 outcome. Objective In here we analyze the clinical characteristics and outcomes of diabetic COVID-19 patients Kuwait. Methods In this single-center, retrospective study of 417 consecutive COVID-19 patients, we analyze and compare disease severity, outcome, associated complications, and clinical laboratory findings between diabetic and non-diabetic COVID-19 patients. Results COVID-19 patients with diabetes had more ICU admission than non-diabetic COVID-19 patients (20.1% vs. 16.8%, p<0.001). Diabetic COVID-19 patients also recorded higher mortality in comparison to non-diabetic COVID-19 patients (16.7% vs. 12.1%, p<0.001). Diabetic COVID-19 patients had significantly higher prevalence of comorbidities, such as hypertension. Laboratory investigations also highlighted notably higher levels of C-reactive protein in diabetic COVID019 patients and lower estimated glomerular filtration rate. They also showed a higher incidence of complications. logistic regression analysis showed that every 1 mmol/L increase in fasting blood glucose in COVID-19 patients is associated with 1.52 (95% CI: 1.34 – 1.72, p<0.001) times the odds of dying from COVID-19. Conclusion Diabetes is a major contributor to worsening outcomes in COVID-19 patients. Understanding the pathophysiology underlining these findings could provide insight into better management and improved outcome of such cases. Highlights of the Study A significantly higher proportion of COVID-19 patients with diabetes mellitus required admission to the ICU. Higher fasting blood glucose was associated with higher risk of COVID-19 associated mortality. COVID-19 patients with diabetes mellitus had significantly higher incidence of complications including sepsis, ARDS, cardiac failure and renal failure.