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Original Research
Clinical Characteristics and Outcomes of Patients With Diabetes and COVID-19 in Association With Glucose-Lowering Medication
Yuchen Chen, Dong Yang, Biao Cheng, Jian Chen, Anlin Peng, Chen Yang, Chong Liu, Mingrui Xiong, Aiping Deng, Yu Zhang, Ling Zheng, Kun Huang
Diabetes Care 2020 May; dc200660. https://doi.org/10.2337/dc20-0660
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Abstract

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

RESEARCH DESIGN AND METHODS In this retrospective study involving 904 patients with COVID-19 (136 with diabetes, mostly type 2 diabetes), clinical and laboratory characteristics were collected and compared between the group with diabetes and the group without diabetes, and between groups taking different medications. Logistic regression was used in order to explore risk factors associated with mortality or poor prognosis.

RESULTS The proportion of comorbid diabetes is similar between cases of confirmed and of clinically diagnosed COVID-19. Risk factors for higher mortality of patients with diabetes and COVID-19 were older age (adjusted odds ratio [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]; 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 those who use an ACE inhibitor (ACEI) or angiotensin II type-I receptor blocker (ARB) were comparable with those of patients who do not use ACEI/ARB among patients with diabetes and hypertension who have COVID-19.

CONCLUSIONS C-reactive protein may help to identify patients with diabetes who are at greater risk of dying during hospitalization. Older patients with diabetes were prone to death related to COVID-19. Attention needs to be paid to patients with diabetes and COVID-19 who use insulin. ACEI/ARB use showed no significant impact on patients with diabetes and hypertension who have COVID-19.

Footnotes

  • This article contains supplementary material online at https://doi.org/10.2337/figshare.12194748.

  • This article is part of a special article collection available at https://care.diabetesjournals.org/collection/diabetes-and-COVID19.

  • Received March 28, 2020.
  • Accepted April 24, 2020.
  • © 2020 by the American Diabetes Association
https://www.diabetesjournals.org/content/license

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at https://www.diabetesjournals.org/content/license.

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Diabetes Care: 44 (3)

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Clinical Characteristics and Outcomes of Patients With Diabetes and COVID-19 in Association With Glucose-Lowering Medication
Yuchen Chen, Dong Yang, Biao Cheng, Jian Chen, Anlin Peng, Chen Yang, Chong Liu, Mingrui Xiong, Aiping Deng, Yu Zhang, Ling Zheng, Kun Huang
Diabetes Care May 2020, dc200660; DOI: 10.2337/dc20-0660

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Clinical Characteristics and Outcomes of Patients With Diabetes and COVID-19 in Association With Glucose-Lowering Medication
Yuchen Chen, Dong Yang, Biao Cheng, Jian Chen, Anlin Peng, Chen Yang, Chong Liu, Mingrui Xiong, Aiping Deng, Yu Zhang, Ling Zheng, Kun Huang
Diabetes Care May 2020, dc200660; DOI: 10.2337/dc20-0660
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© 2021 by the American Diabetes Association. Diabetes Care Print ISSN: 0149-5992, Online ISSN: 1935-5548.