COVID Deaths High When Hospitalized With Diabetes

By Ernie Mundell and Robert Preidt

HealthDay Reporters

THURSDAY, February 18, 2021 (HealthDay News) – Diabetes is a significant risk factor for a severe episode of COVID-19, and a new European study confirms it: it reveals that one in 5 hospital patients with COVID-19 has diabetes dies within 28 days of admission.

An American expert was not surprised by this grim finding.

“Patients with diabetes are clearly in a very high risk category and should be among the first groups of people to get vaccinated,” said Dr Mangala Narasimhan, who heads intensive care services at Northwell Health in New Hyde Park, NY. She also advises people with diabetes to make sure they are in control of their blood sugar levels and to avoid any complications from the disease.

Such milestones “really seem to make a difference in terms of survival from COVID infection,” said Narasimhan, who was not involved in the new study.

The research was conducted by Bertrand Cariou and Samy Hadjadj, diabetologists at the Nantes University Hospital in France. In May of last year, they released preliminary results which showed 10% of COVID-19 patients with diabetes died within seven days of being admitted to hospital.

The most recent and updated results come from a larger number of patients – nearly 2,800 – treated for COVID-19 in 68 hospitals across France. Their average age was 70, almost two-thirds were men, and many were overweight. About 40% also suffered from various forms of complications related to their diabetes.

In the 28 days following their admission to hospital, 21% of patients died, the French team reported on February 17 in the newspaper Diabetology.

Of the patients who survived at least one month, 50% were discharged from the hospital with a median stay of nine days; 12% were still hospitalized on day 28 and 17% had been transferred from their first hospital to another facility.

Younger age, routine treatment of diabetes using the drug metformin, and having symptoms longer before admission to hospital were key factors associated with a higher likelihood of discharge from hospital , the researchers said.

Continued

Patients who took insulin regularly – possibly indicating more advanced diabetes – had a 44% higher risk of death than those who did not take insulin, investigators said. Long-term glycemic control was not associated with patient outcomes, but higher blood sugar levels at the time of hospital admission was a strong predictor of death and decreased risk of exit.

Dr. Barbara Keber directs family medicine at Glen Cove Hospital in Glen Cove, New York Reading the results, she said they show that “diabetes is clearly a significant risk factor for both critical care needs. / ventilators in hospital only for death ‘within one month of admission.

Keber said it “made sense” that people with complications from poorly controlled diabetes are at higher risk, as it creates a “pro-inflammatory state” similar to that seen in advanced COVID-19.

But Keber also warned that death rates may have improved for patients with COVID-19, including those with diabetes, over the past year.

“This study was carried out during the first wave of the pandemic, and many current treatment regimens and drugs that were tried in the early phase have been shown to be ineffective and other treatment regimens have taken their place,” a- she noted.

For example, “the current use of steroids for treatment may play a role in the [improved] prognosis for patients as a whole and in particular for those with diabetes, ”Keber said.

More information

The American Diabetes Association has more on COVID-19.

SOURCES: Mangala Narasimhan, DO, director, intensive care services, Northwell Health, New Hyde Park, NY; Barbara Keber, MD, president, family medicine, Glen Cove Hospital, Glen Cove, NY; Diabetology, press release, February 17, 2021

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