The outcomes of patients with diabetes mellitus in The Philippine CORONA Study

Authors

Adrian I. Espiritu, University of the Philippines College of Medicine
Harold Henrison C. Chiu, University of the Philippines Manila
Marie Charmaine C. Sy, University of the Philippines Manila
Veeda Michelle M. Anlacan, University of the Philippines Manila
Corina Maria Socorro A. Macalintal, Asian Hospital and Medical Center, Muntinlupa
Joanne B. Robles, Asian Hospital and Medical Center, Muntinlupa
Paulo L. Cataniag, Baguio General Hospital and Medical Center
Manolo Kristoffer C. Flores, Baguio General Hospital and Medical Center
Noreen Jhoanna C. Tangcuangco-Trinidad, Cagayan Valley Medical Center
Dan Neftalie A. Juangco, Capitol Medical Center
Giuliani Renz G. Paas, Capitol Medical Center
Audrey Marie U. Chua, Cardinal Santos Medical Center
Valmarie S. Estrada, Cardinal Santos Medical Center
Philip Rico P. Mejia, Cardinal Santos Medical Center
Therese Franz B. Reyes, Cardinal Santos Medical Center
Maria Teresa A. Cañete, Chong Hua Hospital
Ferdinand Renfred A. Zapata, Chong Hua Hospital
Franko Eugenio B. Castillo, De La Salle Medical and Health Sciences Institute
Romulo U. Esagunde, De La Salle Medical and Health Sciences Institute
Jean B. Gantioque, De La Salle Medical and Health Sciences Institute
Maritoni C. Abbariao, Dr. Jose Rodriguez Memorial Medical Hospital and Sanitarium
Geramie M. Acebuque, Dr. Jose Rodriguez Memorial Medical Hospital and Sanitarium
Evram V. Corral, Dr. Pablo O. Torre Memorial Hospital
Marian Irene C. Escasura, East Avenue Medical Center
Marissa T. Ong, East Avenue Medical Center
Krizelle Fowler, Institute for Dementia Care Asia
Arnold Angelo M. Pineda, Jose B. Lingad Memorial Regional Hospital
Khasmeen D. Aradani, Jose B. Lingad Memorial Regional Hospital
Joseree Ann S. Catindig, Jose R. Reyes Memorial Medical Center
Mark Timothy T. Cinco, Jose R. Reyes Memorial Medical Center
Mark Erving H. Ramos, Jose R. Reyes Memorial Medical Center
Romulus Emmanuel H. Cruz, Lung Center of the Philippines
Marita B. Dantes, Lung Center of the Philippines

Publication Date

12-1-2021

Document Type

Article

Publication Title

Scientific Reports

Abstract

Patients diagnosed with diabetes mellitus (DM) who are infected with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) belong to the most vulnerable patient subgroups. Emerging data has shown increased risks of severe infections, increased in ICU admissions, longer durations of admission, and increased mortality among coronavirus disease 2019 (COVID-19) patients with diabetes. We performed a subgroup analysis comparing the outcomes of patients diagnosed with DM (n = 2191) versus patients without DM (n = 8690) on our data from our study based on a nationwide, comparative, retrospective, cohort study among adult, hospitalized COVID-19 patients involving 37 hospital sites from around the Philippines. We determined distribution differences between two independent samples using Mann–Whitney U and t tests. Data on the time to onset of mortality, respiratory failure, intensive care unit (ICU) admission were used to build Kaplan–Meier curves and to compute for hazard ratios (HR). The odds ratios (OR) for longer ventilator dependence, longer ICU stay, and longer hospital stays were computed via multivariate logistic regression. Adjusted hazard ratios (aHR) and ORs (aOR) with 95% CI were calculated. We included a total of 10,881 patients with confirmed COVID-19 infection (2191 have DM while 8690 did not have DM). The median age of the DM cohort was 61, with a female to male ratio of 1:1.25 and more than 50% of the DM population were above 60 years old. The aOR for mortality was significantly higher among those in the DM group by 1.46 (95% CI 1.28–1.68; p < 0.001) as compared to the non-DM group. Similarly, the aOR for respiratory failure was also significantly higher among those in the DM group by 1.67 (95% CI 1.46–1.90). The aOR for developing severe COVID-19 at nadir was significantly higher among those in the DM group by 1.85 (95% CI 1.65–2.07; p < 0.001). The aOR for ICU admission was significantly higher among those in the DM group by 1.80 (95% CI 1.59–2.05) than those in the non-DM group. DM patients had significantly longer duration of ventilator dependence (aOR 1.33, 95% CI 1.08–1.64; p = 0.008) and longer hospital admission (aOR 1.13, 95% CI 1.01–1.26; p = 0.027). The presence of DM among COVID-19 patients significantly increased the risk of mortality, respiratory failure, duration of ventilator dependence, severe/critical COVID-19, ICU admission, and length of hospital stay.

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