Clinical Characteristics and Risk Factors for Disease Severity and Mortality of COVID-19 Patients with Diabetes Mellitus in Kazakhstan: A Nationwide Study

Background: Diabetes mellitus (DM) is associated with higher risk of developing infectious disease and COVID-19 is not the exception. There is a need to generate more data on clinical characteristics and risks of COVID19 patients presenting with DM. In this retrospective study we aimed to report on demographic features, clinical data, and outcomes of COVID-19 patients with DM in comparison with age- and sex-matched patients without DM. Methods: This was a retrospective study that relied on the nationwide data on all COVID-19 patients who were diagnosed from 14 March to 18 April, 2020. Overall, there were 31 cases with DM for which we randomly matched 4 patients without DM by age and sex. Results: COVID-19 patients with associated DM had less beneficial outcomes and more severe disease course both at hospital admission and final diagnosis, as compared with the age and sex- matched non-DM patients. Diabetics were more predisposed to impaired breathing (29.0% versus 4.9% in controls), nausea/vomiting (6.5% versus 0% in controls) and weakness/lethargy (45.2% versus 26.0% in controls). Finally, 48.4% of diabetics showed the signs of pneumonia on CT scans versus 20.3% of non-diabetics (p = 0.001), and 32.3% of DM patients were admitted to intensive care units as compared with just 5.7% of non-DM patients (p<0.001). Conclusion: There is a need to envisage early status monitoring and supportive care in this vulnerable category of patients to enable better prognosis. Funding Statement: This study received no funding. Declaration of Interests: There is no conflict of interest to declare for any of the authors. Ethics Approval Statement: Before the study beginning, we obtained the permission from Ethical Committee of Semey Medical University, Semey, Republic of Kazakhstan. Because only anonymized medical records were available to the study team, the ethical committee waived informed consent.