Clinical characteristics, risk factors and complication of severe and critical illness of COVID-19 with Type 2 diabetes mellitus

Abstract

Background: The risk of COVID-19 infection, mortality and prognosis are negatively affected by the presence of comorbidities, especially in patients with type 2 diabetes mellitus (T2DM). In many countries with the spread of COVID-19, we can see many studies conducted among the population but in Mongolia, there is no research about the risk prognosis and mortality of patient hospitalized in the Intensive Care Unit (ICU) with COVID-19 infection have been related to the risk and mortality. Aim: To study the clinical features, complications and prognosis of patients with severe COVID-19 infection and diabetes. Materials and Methods: In the study, a total of 202 cases with confirmed COVID-19 infection and treated in the ICU of the Mongolian-Japanese Hospital (MJH) from April 18 to December 1, 2021 were selected and included using a targeted sampling method. Results: All patient were classified into 2 groups: diabetic and non-diabetic, the group with diabetes had 3-5 comorbidities (p<0.0001). Among the comorbidities, hypertension accounted for 71.1% (p=0.002). Patient with diabetes were severe, critical illness (p=0.032) and required more oxygen (p=0.023) when they arrived at the intensive care unit. When comparing the imaging tests of these patients at the time of arrival to the ICU, 66.6% of the group with DM had bilateral pneumonia (p=0.002). In addition, 73.3% (p=0.032) of the patient with diabetes had ARDS and 23.3% (p<0.0001) of sepsis, them required vasopressor treatment due to complications. Total hospital bed days and ICU bed days (p=0.016, p=0.046) were significantly different in the group with DM. There was no significant difference in 30and 90-day mortality. Conclusions: 1. 44.5% of all the treated patients had DM. There were more comorbidities in patients treated with DM, and hypertension, cardiovascular disease, kidney disease accounted for the majority. 2. These patients were seriously ill with Covid-19 and more complication by respiratory failure, pneumonia, ARDS and sepsis. And hospital and ICU days were long. 3. 16.8% of critical ill patients infected with Covid-19 were died. No significant 30 and 90day mortality was identified for these patients.