Predictors of adverse in-hospital outcome and recovery in patients with diabetes mellitus and COVID-19 pneumonia in Iraq

Abstract

Background and aims

There is limited data about the prognosis and impact of COVID-19 pneumonia on patients with diabetes mellitus (DM). We aimed to assess blood indices, ECG markers of sudden death and malignant arrhythmias on admission, and diabetes lowering drugs as possible predictors of adverse in-hospital outcome and COVID-19 pneumonia recovery status.

Methods

A retrospective study included patients with newly diagnosed COVID-19 pneumonia from August 20, to October 5, 2020.

Results

A total of 192 patients with COVID-19 pneumonia were included in the present study, of whom 67 patients had DM. Low lymphocytes % [0.4(0.1–0.9), P = .011] and QTc interval prolongation [0.4(0.1–0.8), P = .022] were associated with increased length of ICU stay. On the other hand, metformin use [0.3(0.2–4), P = .032] and DPP-4 inhibitors use [0.3(0.2–3), P = .040] were associated with decreased length of ICU stay. QTc interval prolongation [0.4(0.1–0.9), P = .017] was associated with increased length of hospital stay, while using metformin [0.4(0.2–3), P = .022] was associated with decreased length of hospital stay. Low lymphocytes % [0.5(0.4–1.6), P = .001], insulin use [0.4(0.3–5), P = .003], and old age [0.5(0.1–2.3), P = .025] were associated with extensive lung injury. The risk for in-hospital death was associated with high neutrophil% [1(1–1.4), P = .045], while metformin use was associated with decreased risk for in-hospital death [0.1(0.1–0.6), P = .025]. Insulin use [0.3(0.2–4), P = .013] was associated with partial recovery following acute COVID pneumonia.

Conclusions

Metformin and DPP-4 inhibitors use were associated with favorable in-hospital outcomes, while insulin use was associated with extensive lung injury and post-acute COVID-19 pneumonia partial recovery.

Highlights

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  Metformin and DPP-4 inhibitors use were associated with favorable in-hospital outcomes.

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  Insulin use was associated with extensive lung injury and partial recovery following acute COVID-19 pneumonia.

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  Low lymphocyte %, high neutrophil %, old age, and ↑ QTc were predictors of adverse outcome in patients with DM and COVID-19.