Clinical Characteristics and Outcomes of Patients With Diabetes and COVID-19 in Association With Glucose Lowering Medication

OBJECTIVE: Diabetes is one of the most distinct comorbidities of COVID-19. Here, we described the clinical characteristics and outcomes in diabetic patients with confirmed or clinically diagnosed (with typical lung imaging features and symptoms) COVID-19, and their association with glucose lowering or blood pressure lowering medications.

RESEARCH DESIGN AND METHODS: In this retrospective study involving 904 COVID-19 patients (136 with diabetes, mostly type 2 diabetes), clinical and laboratory characteristics were collected and compared between diabetic vs non-diabetic groups, and different medication groups. Logistic regression was used to explore risk factors associated with mortality or poor prognosis.

RESULTS: Proportion of comorbid diabetes is similar between confirmed and clinically diagnosed COVID-19 cases. Risk factors for higher mortality of diabetic patients with COVID-19 were elder age (adjusted OR [aOR] 1.09 [95% CI 1.04, 1.15], per year increase, P = 0.001) and elevated C-reactive protein (aOR 1.12 [95% CI 1.00, 1.24], mg/dL, P = 0.043). Insulin usage (aOR 3.58 [95%CI 1.37, 9.35], P = 0.009) was associated with poor prognosis. Clinical outcomes of ACE inhibitor or angiotensin II type-I receptor blocker (ACEI/ARB) users were comparable to non-ACEI/ARB users in COVID-19 patients with diabetes and hypertension.

CONCLUSIONS: C-reactive protein may help to identify diabetic patients with greater risk. Elder diabetic patients were prone to COVID-19-related fatality. Attentions need to be paid on insulin-using diabetic patients with COVID-19. ACEI/ARB showed no significant impact on COVID-19 patients with diabetes and hypertension.