In a new study, researchers analyzed the outcomes of patients with diabetes admitted to hospital with COVID-19.
They found that one in five patients die within 28 days while around half are discharged.
The research was conducted by a team at University Hospital Nantes in France.
In May 2020, the team showed that 10% of patients with diabetes and COVID-19 died within 7 days of hospital admission.
This updated analysis included 2796 participants from 68 centers across France: almost two-thirds (64%) were men, mean age 70 years, and overweight.
Diabetic complications were found in about 40% of participants.
The team found that within 28 days, 1404 (50%) of the patients were discharged from the hospital with a duration of hospital stay of 9 days, while 577 participants died (21%).
Of the remaining patients, 12% remained hospitalized at day 28, while 17% had been transferred to facilities different from their initial hospital.
Computer modeling showed various factors such as younger age, routine diabetes therapy with the drug metformin, and longer symptom duration on admission were linked to a higher chance of discharge from the hospital.
On the other hand, history of microvascular complications, routine anticoagulant therapy (to prevent blood clots), shortness of breath on admission, abnormal levels of liver enzymes, higher white blood cell counts and higher levels of the systemic inflammatory marker C-reactive protein were all associated with a lower chance of discharge and a higher risk of death.
Patients whose diabetes was regularly treated with insulin (possibly indicating a more advanced state of diabetes) were at a 44% increased risk of death compared with those not treated with insulin.
An unusual finding from this study was a 42% increased risk of death for patients with diabetes receiving statin treatment for high cholesterol.
The study also found that long-term blood sugar control assessed with pre-admission or admission glycated haemoglobin (HbA1c) did not impact the fate of COVID-19 patients.
In contrast, an increased level of plasma glucose on admission was a strong predictor of death and, consistently, of a lower chance of discharge.
One author of the study is Professor Bertrand Cariou.
The study is published in Diabetologia.
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