People with diabetes at risk for severe COVID-19, study confirms

A recent study from the University of Cape Town (UCT) confirmed that people living with diabetes (PLWD) are at increased risk of severe COVID-19 (hospitalization and mortality). The results were published in the journal Diabetes Research and Clinical Practice.

Researchers used data from the first wave of the pandemic in the Western Cape, from March 4, 2020 (when the first case was identified) to July 15, 2020, when infection rates plummeted.

During this period, 64,476 people were diagnosed with COVID-19, of which 9,305 were people with disabilities. Among COVID-19 diabetic patients, 44.9% were hospitalized, 4.0% were admitted to an intensive care unit (ICU), 0.6% received ventilation, and 15.4% died. This, compared to COVID-19 patients without diabetes: 12.2% were hospitalized, 1.0% were admitted, 0.1% were ventilated, and 4.6% died.

“We found that age, male gender, diabetes, current tuberculosis, HIV infection and chronic kidney disease were significantly associated with hospital admission and mortality. In people with disabilities, HIV infection, chronic kidney disease, current tuberculosis, male sex and increasing age were significantly associated with hospital admission and mortality, ”he said. declared the principal investigator and head of UCT Division of Endocrinology, Associate Professor Joel Dave.

Increased risk

Associate Professor Dave said the results showed an increased risk of hospital admission, intensive care admission and death in people diagnosed with COVID-19 who have diabetes, with nearly half of all deaths from COVID-19 occurring in people with disabilities.

“After adjusting for various variables such as age, sex, and co-morbid illnesses, including HIV status, people with disabilities had almost four times the risk of hospitalization and three times the risk of death compared to people without. diabetics, ”he said.

The study confirms the previous results of an analysis carried out before June 1, 2020 on death from COVID-19 in the general population, associated with age, males, chronic kidney disease and in those affected active tuberculosis and HIV.

“It is our responsibility as health care providers to provide training and close monitoring of risks to people with disabilities. “

Dave said the diabetic population is at high risk, possibly due to more limited access to optimal diabetes care.

“We have also found that concomitant HIV infection or chronic kidney disease and diabetes are associated with more severe disease and that the use of metformin, in particular, is associated with reduced mortality,” a- he declared. “These findings are of major importance to public health, which begs the question of how to improve the high risk of PLWD during this COVID-19 pandemic. “

He continued, “It is incumbent on us as healthcare providers to provide training and close monitoring of risks to people with disabilities. It is too early to recommend the widespread use of metformin. Additional interventions for people with disabilities diagnosed with COVID-19 may include monitoring home oxygen saturation, ensuring adequate glycemic control, early identification of worsening symptoms with early access to admission to hospital. hospital and consideration of preventive hospital admission for people with disabilities who are considered to be at very high risk of severe COVID-19. “

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