Age, comorbidities, remedy use amongst predictors for extreme COVID-19 in diabetes

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Virmani S. Diabetes and COVID-19: Identifying Diabetes-Related Predictors for Severe Infections. Presented at: American Association of Clinical Endocrinology Annual Scientific and Clinical Conference; 26.-29. May 2021 (virtual meeting).

Disclosure:
Virmani does not report any relevant financial information.

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Older age, obesity, cardiovascular disease, and pre-hospital use of steroids and SGLT2 inhibitors are among the factors that increase the risk of severe COVID-19 in people with diabetes, according to a spokesman.

Samarth Virmani

“Our study identified the diabetic subpopulation at risk of severe COVID-19 infection and can help clinicians stratify patients based on their risk factors to implement early intensive clinical care to reduce poor outcomes.” Samarth Virmani, MBBS, an internist at the University of Central Florida, HCA Healthcare GME in Orlando, said Healio.

Adults with diabetes who have a BMI greater than 35 kg / m2, Neuropathy, or cardiovascular disease have an increased risk of severe COVID-19 infection. The data was derived from Virmani S. Diabetes and COVID-19: Identifying Predictors of Severe Infections Associated with Diabetes. Presented at: American Association of Clinical Endocrinology Annual Scientific and Clinical Conference; 26.-29. May 2021 (virtual meeting).

Virmani and colleagues conducted a multicenter retrospective study of 1,818 people with diabetes who were hospitalized with COVID-19. Patients admitted to the intensive care unit who died or met clinical criteria suggestive of airway decompensation were defined as patients with severe COVID-19. The researchers collected data on demographics, BMI, HbA1c, diabetes complications, comorbidities, and pre-hospital medication use. The results were presented at the annual meeting of the American Association of Clinical Endocrinology.

People with diabetes likely had severe COVID-19 when they were older (OR = 1.01) or male (OR = 1.37). People with a BMI of more than 35 kg / m2 (OR = 1.83), neuropathy (OR = 1.65) or cardiovascular diseases (OR = 1.3) also had an increased risk of COVID-19. Use of steroids (OR = 1.49) or SGLT2 inhibitors (OR = 1.85) prior to hospitalization increased the risk of severe COVID-19, while in those on ACE inhibitors (OR = 0.75) or Taking statins, a lower risk of serious infections was observed (OR = 0.66).

“We were surprised to find that pre-hospital steroid use, which is now a common treatment option for hospitalized COVID-19 patients, can be harmful and increase the severity of COVID-19 in diabetics,” said Virmani .

People with diabetes and severe COVID-19 infection had a higher rate of hyperglycemia than people with non-severe infection (44.35% versus 37.6%). The proportion of patients with hypoglycemia was also higher in people with severe infection compared to patients with non-severe infection (9.75% versus 8.9%).

Virmani said the study’s results could help vendors identify people with diabetes who may be at greatest risk for severe COVID-19.

“Future prospective studies and clinical trials can confirm the results of our study and determine whether early, intensive clinical care in vulnerable diabetics can reduce poor outcomes,” said Virmani. “These studies can also improve our understanding of the effects of COVID-19 on diabetics, which can ultimately lead to standardized clinical care for vulnerable diabetics.”

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Annual meeting of the American Association of Clinical Endocrinology

Annual meeting of the American Association of Clinical Endocrinology