Abstract #1003696: Diabetes and COVID-19: Identifying Diabetes-Related Predictors of Severe Infection

https://doi.org/10.1016/j.eprac.2021.04.577Get rights and content

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Objective

Since the emergence of the COVID-19 pandemic, the scientific community has been hard at work identifying patients who are most susceptible to poor outcomes. Diabetes has been established as a major risk factor. Our study aims to identify which sub-population of diabetic patients are most vulnerable.

Methods

We performed a multicenter retrospective study of 1,796 diabetic patients with 1,818 distinct hospital admissions. The outcome of severe COVID-19 infection was defined based on ICU admission, mortality, and clinical criteria indicating respiratory decompensation. Logistic regression analysis was performed for different variables to identify the odds of experiencing severe infection. We examined demographic characteristics, body mass index, HbA1C, presence of diabetes complications and metabolic

Results

Our study showed statistically-significant increased odds of experiencing severe infection with older age (OR=1.018), male gender (OR=1.371), BMI >35 (OR=1.838), nephropathy (OR=1.659), and cardiovascular disease (OR=1.3). An increased risk was observed in patients with pre-hospitalization exposure to steroids (OR=1.498) and SGLT-2 inhibitors (OR=1.856); whereas the risk was decreased with ACEI (OR=0.75) and statins (OR=0.661). Other variants were not associated with significant changes in

Discussion/Conclusion

Our study outlines a risk profile for severe infection in diabetic patients. The findings of this study can help identify diabetics who are at highest risk. Older age, obesity, and the presence renal and cardiac disease are all risk factors that have been linked to impaired immune response to infections. Interestingly, pre-hospitalization use of steroids, which is now a common treatment option for hospitalized COVID patients, could be detrimental. SGLT-2 inhibitors prior to hospitalization

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