Background: The transmissibility and severity of coronavirus disease 2019 (COVID-19) are higher in the delta variant (B.1.617.2) infection responsible for Indonesia's second epidemic wave. This study aimed to establish an epidemiological profile of COVID-19 in patients with diabetes mellitus, a comorbid that has been widely suggested for its association with increased severity and mortality.
Methods: This study employed a retrospective observation on medical records from May to December 2021. Patients (n=115) aged >18 presented with COVID-19 and diabetes mellitus were enrolled. The SARS-CoV-2 infection was confirmed by a pharyngeal swab sample's reverse transcription-quantitative polymerase chain reaction (RT-qPCR). The diabetic condition was determined by previous medical records and persistent level of random blood sugar (RBS) of >200 mg/dL. Demographic, clinical characteristics, COVID-19 symptoms, radiological findings, and hematological and coagulopathy markers were collected from the medical records. The data were presented as frequency (%) assigned based on severity levels: mild, moderate, severe, and critical COVID-19.
Results: A group of patients aged 50—59 years had higher prevalence of severe COVID-19 (n=14; 28.6%) than the other groups. Severe cases were relatively more common in a group with body mass index (BMI) ranged from 30—<35 kg/m2 (n=13; 27.1%). Notably higher number of severe cases was recorded in patients having <3.5 mg/dL albumin (n=11 out of 50), >200 mg/dL RBS (n=22 out of 93), and ≥1 μg/mL D-dimer (n=18 out of 73). Critical COVID-19 cases were found in those with C-reactive protein levels of <5 mg/L (n=6; 6.8%) and procalcitonin levels of ≥0.05 ng/mL (n=6; 7.1%). Patients who had stage 1 and 3 chronic kidney disease (CKD) were found to develop critical COVID-19 with a frequency of 5.9% (n=2) and 10.5% (n=4), respectively.
Conclusion: The severity of COVID-19 in diabetic patients is indicatively associated with the age, BMI, hematological and coagulopathy markers, and CKD. Active monitoring of these parameters in diabetic COVID-19 patients is encouraged.