Prevalence of diabetes, management and outcomes among Covid-19 adult patients admitted in a specialized tertiary hospital in Riyadh, Saudi Arabia
Diabetes Research and Clinical Practice, doi:10.1016/j.diabres.2020.108538
This retrospective study aimed to characterize comorbidities and associated with mortality among hospitalized adults with Covid-19 managed as per the Saudi Ministry of Health protocol in a specialized tertiary hospital in Riyadh, Saudi Arabia. Medical records of 300 adult patients with PCR-confirmed SARS-CoV2 infection and admitted in King Salman Hospital (KSH) from May 1 to July 31, 2020 were included. Medical history, management and outcomes were noted. Males significantly outnumber females (259 versus 41). South Asians comprise 41% of all admitted patients. Mortality rate was 10% and highest among Saudi males (28.9%). Type 2 diabetes mellitus (T2DM) was the most common comorbidity (45.7%). Almost all patients (99%) had pneumonia. Patients > 50 years were three times more likely to die (confidence interval, CI 1.3-6.9; p = 0.01) from Covid-19. Congestive heart failure (odds ratio OR 19.4, CI-1.5-260.0; p = 0.02) and acute kidney injury (OR 11.7,; p < 0.001) were significantly associated with higher mortality. Dexamethasone use significantly improved the final outcome based on net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (p < 0.05). In this single-center study, T2DM was very common among hospitalized Covid-19 patients. Patients > 50 years, those with congestive heart failure and acute kidney injury are at higher risk for worse Covid-19 outcome.
Authors' Contributions ES and SS designed the study. RMA, AAS, KSA, KA and HAA worked in the methodology. SS and NMA did the formal analysis. ES, RMA, AAS, KSA, KA and HAA helped in the data curation. SS wrote the original and revised draft. ES, RMA, AAS, KSA, KA, HAA and NMA handled manuscript review ES and NMA did the study supervision.
Declaration of Competing Interest The authors declare that they have no competing interest.
Abdi, Jalilian, Sarbarzeh, Vlaisavljevic, Diabetes and COVID-19: A systematic review on the current evidences, Diab Res Clin Pract
Al-Daghri, Os, Alokail, Diabetes mellitus type 2 and other chronic non-communicable diseases in the central region, Saudi Arabia (Riyadh cohort 2): a decade of an epidemic, BMC Med
Alexander, Debono, Mammen, COVID-19 coronavirus research has overall low methodological quality thus far: case in point for chloroquine/hydroxychloroquine, J Clin Epidemiol
Alsofayan, Althunayyan, Khan, Hakawi, Assiri, Clinical characteristics of COVID-19 in Saudi Arabia: A national retrospective study, J Infect Public Health
Arshad, Kilgore, Chaudhry, Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19, Int J Infect Dis
Castelnuovo, Costanzo, Antinori, Use of hydroxychloroquine in hospitalised COVID-19 patients is associated with reduced mortality: Findings from the observational multicentre Italian CORIST study, Eur J Intern Med
Catteau, Dauby, Montourcy, Low-dose Hydroxychloroquine Therapy and Mortality in Hospitalized Patients with COVID-19: A Nationwide Observational Study of 8075 Participants, Int J Antimicrob Agents
Del Sole, Farcomeni, Loffredo, Carnevale, Menichelli et al., Features of severe Covid-19: a systematic review and meta-analysis, Eur J Clin Invest
Gustafson, Raju, Wu, Ching, Veitch et al., Overcoming barriers: the endothelium as a linchpin of coronavirus disease 2019, Arterioscler Thromb Vasc Biol
Hasan, Capstick, Ahmed, Mortality in COVID-19 patients with acute respiratory distress syndrome and corticosteroids use: a systematic review and meta-analysis Expert, Rev Respir Med
Ip, Berry, Hansen, Hydroxychloroquine and tocilizumab therapy in COVID-19 patients-An observational study, PLoS ONE
Khaled, Gray, Depression in migrant workers and nationals of Qatar: An exploratory cross-cultural study, Int J Soc Psychiatry
Liang, Liu, Chen, Ye, Li et al., Characteristics of laboratory findings of COVID-19 patients with comorbid diabetes mellitus, Diab Res Clin Pract
Macauley, Martin, Epelbaum, Corticosteroids in the treatment of severe covid-19 lung disease: the pulmonology perspective from the first United States epicenter, Int J Infect Dis
Magagnoli, Narendran, Pereira, Cummings, Hardin et al., Outcomes of hydroxychloroquine usage in United States Veterans hospitalized with Covid-19, Med
Mishra, Ghimire, Joshi, Cardio-metabolic disease risk factors among South Asian labour migrants to the Middle East: a scoping review and policy analysis, Global Health
Okada, Yoshida, Hara, Ogura, Tomita, Vascular endothelial injury exacerbates coronavirus disease 2019: the role of endothelial glycocalyx protection, Microcirculation
Recovery Collaborative Group, Horby, Lim, Emberson, Mafham et al., Dexamethasone in Hospitalized Patients with Covid-19 -Preliminary Report, N Engl J Med
Wu, Tang, Cheng, Diabetes increases the mortality of patients with COVID-19: a meta-analysis, Acta Diabetol