Diabetes mellitus and severity by COVID-19 in hospitalized Brazilians
Objective: to estimate the prevalence of severity of hospitalized cases of COVID-19 and its association with diabetes mellitus. Methods: a cross-sectional study, which used secondary data from the Influenza Epidemiological Surveillance Information System, totaling 405,294 confirmed cases. To verify the association of diabetes and severity in hospitalized patients with COVID-19, Poisson regression models with robust variance estimator were used. Initially, the association of disease with outcome was verified; next, several adjustments for potential confounders were performed. Results: the prevalence of diabetes in the 405,294 hospitalized and positive cases was 25.7% (Confidence Interval: 25.5% - 25.8%). After adjustments, diabetes was found to increase the severity of COVID-19 by 19% (Confidence Interval: 1.17 - 2.21). Conclusion: a significant association of diabetes mellitus with severe cases of COVID-19 infection has been identified. Contributions to practice: the evidence generated by the study guides the risk stratification of patients and directs clinical management.
Borges DB, Lacerda JT. Actions aimed at the Diabetes Mellitus control in Primary Health Care: a proposal of evaluative model. Saúde debate 2018; 42(116). https://doi.org/10.1590/0103-1104201811613.
Palaiodimos L, Chamorro-Pareja N, Karamanis D, Li W, Zavras PD, Chang KM, et al. Diabetes is associated with increased risk for in-hospital mortality in patients with COVID-19: a systematic review and meta-analysis comprising 18,506 patients. Hormones. 2021; 20(2):305–14, 2021. https://doi.org/10.1007/s42000-020-00246-2.
Sombra LRS, Lo KB, Chacko S, Mendes Neto AG, Azmaiparashvili Z, Patarroyo-Aponte G, et al. Insulin Use, Diabetes Control, and Outcomes in Patients with COVID-19. Endocr Res. 2021; 46(2):45-50. 10.1080/07435800.2020.1856865.
Gregory JM, Slaughter JC, Duffus SH, Smith TJ, LeStourgeon LM, Jaser SS, et al. COVID-19 severity is tripled in the diabetes community: a prospective analysis of the pandemic’s impact in type 1 and type 2 Diabetes. Diabetes care., 2021; 44(2): 526-32. https://doi.org/10.2337/dc20-2260.
Instituto Brasileiro de Geografia e Estatística. Brasil. IBGE; [cited 2022 jan 12] 2020. Available at: https://www.ibge.gov.br/.
Carr MJ, Wright A, Leelarathna L, Thabit H, Milne N, Kanumilli N, et al. Impact of COVID-19 on diagnoses, monitoring, and mortality in people with type 2 diabetes in the UK. Lancet Diab Endocrinol. 2021; 9(7):413-5. 10.1016/S2213-8587(21)00116-9.
Zahid MN, Perna, S. Continent-wid analysis of COVID-19: total cases, deaths, tests, socio-economic, and morbity factoers associated to the mortality rate, and forecasting analysis in 2020-2021. Int J Environ Res Public Health. 2021; 18(10):5350. 10.3390/ijerph18105350.
Wander PL, Lowy E, Beste LA, Palomino LT, Korpak A, Peterson AC, et al. Risk factors for adverse outcomes among 35 879 veterans with and without diabetes after diagnosis with COVID-19. BMJ Open Diab Res Care. 2021; 9(1). 10.1136/bmjdrc-2021-002252.
Kumar A, Arora A, Sharma P, Anikhindi SA, Bansal N, Singla V, et al. Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis. Diabetes Metab Syndr. 2021; 14(4):535-45. 10.1016/j.dsx.2020.04.044.
Huang I, Lim MA, Pranata R. Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia – A systematic review, meta-analysis, and meta-regression: diabetes and COVID-19. Diabetes Metab Syndr Clin Res Rev 2020; 14:395-403. 10.1016/j.dsx.2020.04.018.
Guo W, Li M, Dong Y, Zhou H, Zhang X, Tian C, et al. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metab Res Rev. 2020; 36(7). 10.1002/dmrr.3319.
Grasselli G, Zangrillo AZ, Zanella A, Antonelli M, Cabrini L, Castelli A, et al. Baseline characteristics and outcomes of 1.591 patientes infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. JAMA. 2020; 323(16):1574-81. 10.1001/jama.2020.5394.
Pérez-Martínez P, Sánchez FJC, Gómez JC, Huelgas RG. Solving one of the pieces of the puzzle: COVID-19 and type 2 diabetes. Rev Clin Esp. 2020; 220(8):507-10. 10.1016/j.rce.2020.05.003.
Garces TS, Sousa GJB, Florêncio RS, Cestari VRF, Pereira MLD, Moreira TMM. COVID-19 in a state fo Brazilian Northeast: prevalence and associated factors in people with flu-like syndrome. J Clin Nurs., 2020; 29(21):4343-48. 10.1111/jocn.15472.
Griadil TI, Chopey IV, Chubirko KI, Hechko MM, Rumaneh W. Assessment of cardiovascular risk in pacients with type 2 diabetes mellitus and associated obesity and ways of its correction. Wiad Lek. 2021; 74(4):998-1002. 10.36740/WLek202104135.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229):1054-62. 10.1016/S0140-6736(20)30566-3.
Sticchi A, Cereda A, Toselli M, Esposito A, Palmisano A, Vignale D, et al. Diabetes and mortality in patients with COVID-19: are we missing the link? Anatol J Cardiol. 2021; 25(6):376-9. 10.5152/AnatolJCardiol.2021.29132.
Muniangi-Muhitu H, Akalestou E, Salem V, Misra S, Oliver NS, Rutter GA. Covid-19 and diabetes: a complex bidirectional relationship. Front Endocrinol. 2020; 11:582936. 10.3389/fendo.2020.582936.
Schofield J, Leelarathna L, Thabit H. COVID-19: Impact of and on Diabetes. Diabetes Ther 2020; 11:1429–35. 10.1007/s13300-020-00847-5.
Shi Z, Yan A, Zimmet P, Sun X, Moreira NCV, Cheskin LJ, Wang L, et al. COVID-19, diabetes, and associated health outcomes in China: results from a Nationwide Survey of 10.545 adults. Horm Metab Res. 2021; 53(5):301-10. 10.1055/a-1468-4535.
Biancalana E, Federico P, Mengozzi A, Solini A. Short-term impact of COVID-19 lockdown on metabolic control of patients with well-controlled type 2 diabetes: a single-centre observational study. Acta Diabetol. 2021; 58(4):431-36. 10.1007/s00592-020-01637-y.
Ghosh A, Arora B, Gupta R, Anoop S, Misra A. Effects of nationwide lockdown during COVID-19 epidemic on lifestyle and other medical issues of patients with type 2 diabetes in north India. Diabetes Metab Syndr. 2020; 14(5):917–20. 10.1016/j.dsx.2020.05.044.
Amarasekera N, Sarker P, Manoharan S. Is there a link between the prevalence of cardiovascular disease, diabetes, kidney disease, chronic obstructive pulmonary disease and malignancies and the severity of COVID-19 within the BAME population? Clin Med. 2021; 21(2):46. 10.7861/clinmed.21-2-s46.
Shakaib B, Zohra T, Ikram A, Shakaib MB, Ali A, Bashir A, et al. A comprehensive review on clinical and mechanistic pathophysiological aspects of COVID-19 Malady: How far have we come? Virol J. 2021; 18(120). 10.1186/s12985-021-01578-0.
Anghebem MI, Rego FGM, Picheth, G. COVID-19 and Diabetes: two distinct pandemics and their relationship. RBAC. 2020; 52(2):154-9. 10.21877/2448-3877.20200001.
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