Diabetes patients with comorbidities had unfavorable outcomes following COVID-19: a retrospective study

Abstract BackgroundPrevious studies have shown that diabetes mellitus is a common comorbidity of Coronavirus Disease 2019 (COVID-19), but the effects of diabetes or antidiabetic medication on the mortality of COVID-19 have not been well described. To investigate the outcome of different statuses (with or without comorbidity) and antidiabetic medication use before admission of patients with diabetes after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, we collected clinical data of patients with COVID-19 and compared those with diabetes versus nondiabetics.MethodsIn this multicenter and retrospective study, we enrolled 1,422 consecutive hospitalized patients from January 21 to March 25, 2020, at six hospitals in Hubei Province, China. The primary endpoint was in-hospital mortality.ResultsPatients with diabetes were 10 years older than nondiabetic patients (p<0.001) and had a higher prevalence of comorbidities such as hypertension (p<0.001), coronary heart disease (CHD) (p<0.001), cerebrovascular disease (CVD) (p<0.001), and chronic kidney disease (CKD) (p=0.007). Mortality (p=0.003) was more prevalent among the diabetes group. Further analysis revealed that patients with diabetes who took acarbose had a lower mortality rate (p<0.01). Multivariable Cox regression showed that male sex (hazard ratio [HR] 2.59 [1.68-3.99]), hypertension (HR 1.75 [1.18-2.60]), CKD (HR 4.55 [2.52-8.20]), CVD (HR 2.35 [1.27-4.33]), and age were risk factors for the COVID-19 mortality. Higher HRs were noted in those aged ≥65 (HR 11.8 [4.6- 30.2]) versus 50-64 years (HR 5.86 [2.27-15.12]). The survival curve revealed that, compared with the diabetes only group, the mortality was increased in the diabetes with comorbidities group (p=0.009) but had was not significantly different from the noncomorbidity group (p=0.59).ConclusionPatients with diabetes had worse outcomes when suffering from COVID-19; however, the outcome was not associated with diabetes itself but with comorbidities. Furthermore, the administration of acarbose could reduce the risk of death in patients with diabetes.