Diabetes, dysglycemia and obesity: their relationship with mortality and demand for health resources during the COVID-19 pandemic (2020-2021) in a community hospital

Authors

  • Guillermo Dieuzeide Nuestra Señora del Carmen Hospital in Chacabuco, Province of Buenos Aires, Argentina
  • Alicia Pagola Nuestra Señora del Carmen Hospital in Chacabuco, Province of Buenos Aires, Argentina
  • Ulises Constancio Nuestra Señora del Carmen Hospital in Chacabuco, Province of Buenos Aires, Argentina
  • Gabriela Agüero Nuestra Señora del Carmen Hospital in Chacabuco, Province of Buenos Aires, Argentina
  • Camila Fernández Nuestra Señora del Carmen Hospital in Chacabuco, Province of Buenos Aires, Argentina
  • Nancy Fannucce Nuestra Señora del Carmen Hospital in Chacabuco, Province of Buenos Aires, Argentina
  • Alberto Quereda Nuestra Señora del Carmen Hospital in Chacabuco, Province of Buenos Aires, Argentina
  • Claudio González Norberto Quirno University Institute Center for Medical Education and Clinical Research, City of Buenos Aires, Argentina

DOI:

https://doi.org/10.47196/diab.v59i2.1192

Keywords:

COVID-19, diabetes, dysglycemia, obesity

Abstract

Introduction: the COVID-19 pandemic led to an increase in global morbidity and mortality that affected the community served at our Hospital, particularly vulnerable individuals with underlying comorbidities.

Objectives: to analyze whether patients with known diabetes mellitus (DM) and dysglycemia at the time of hospital admission and/or during their stay, and those with obesity, had higher mortality compared to patients without these conditions during hospitalizations due to COVID-19 infection (2020-2021). Likewise, to evaluate whether these same patients required increased demand for intensive care unit (ICU) admission and/or mechanical ventilation (MVA).

Materials and methods: a retrospective study was made of 594 patients admitted with a confirmed diagnosis of SARS-CoV-2 virus infection (SARS-CoV-2 TCR antigen immunochromatographic test and/or polymerase chain reaction, PCR) to the Hospital del Carmen de Chacabuco from May 20, 2020, to August 15, 2021. Patients were classified as: a) patients with DM: with a known diagnosis of DM with two previous fasting blood glucose levels >126 mg/dl, HbA1c >6.5%, and/or receiving oral hypoglycemic agents and/or insulin upon admission; b) dysglycemic patients: patients with previously unknown DM who were admitted and/or maintained fasting plasma glucose levels >100 mg/dl and/or postprandial blood glucose levels >180 mg/dl during their hospitalization, requiring insulin for control; (c) normoglycemic patients: those with normal blood glucose levels during their hospitalization; (d) obese patients: those admitted with a body mass index [BMI] >30; (e) normo and/or overweight patients: those with a BMI <30. Mortality rates were compared between groups. Statistical methods: Student t test, chi-square, correlation (Pearson and Spearman), Cox regression.

Results: a total of 594 patients hospitalized with COVID-19 were studied. Age X̄ 61.9 (SD 16.9 years), 56% male, and 44% female. One hundred twenty-seven (127, 21%) were patients with known DM, 309 (52%) had dysglycemia, and 205 were obese (34%). Twenty-nine of 127 patients with known DM (22.8%) died versus 67 of 309 patients with dysglycemia (21.7%), whereas in the group of patients without previous DM and with normal blood glucose during hospitalization, 18 of 158 individuals died (11.4%; p=0.01). Comparing patients with known DM and without DM (considering overall dysglycemic and/or normoglycemic) no significant difference in mortality was observed (22/127 diabetics: 22.8% versus 85/467: 18.5% non-diabetics; p=0.29). Among non-diabetics, 67/309 patients with dysglycemia died (21.7%) versus 18/158 with normoglycemia (11.4%; p=0.009). Of the obese patients, 48/205 (23.4%) versus 22/389 (5.7%) of those with normal weight/overweight required ICU admission (p=0.0001). Adjusting for comorbidities, multivariate analysis found that age (HR: 1.06/year, CI 1.04-1.08; p=0.001) and the presence of obesity (HR: 1.5, CI 1.5-2.0; p=0.004) were associated with higher mortality.

Conclusions: patients with dysglycemia had higher mortality rates during COVID-19 hospitalization compared to those with normoglycemia, a difference similar to that reported by patients with known DM. Obese patients required more ICU admission and needed RMA.

Author Biographies

Guillermo Dieuzeide, Nuestra Señora del Carmen Hospital in Chacabuco, Province of Buenos Aires, Argentina

Teaching and Research Committee

Alicia Pagola, Nuestra Señora del Carmen Hospital in Chacabuco, Province of Buenos Aires, Argentina

Teaching and Research Committee

Ulises Constancio, Nuestra Señora del Carmen Hospital in Chacabuco, Province of Buenos Aires, Argentina

Teaching and Research Committee

Gabriela Agüero, Nuestra Señora del Carmen Hospital in Chacabuco, Province of Buenos Aires, Argentina

Teaching and Research Committee

Camila Fernández, Nuestra Señora del Carmen Hospital in Chacabuco, Province of Buenos Aires, Argentina

Teaching and Research Committee

Nancy Fannucce, Nuestra Señora del Carmen Hospital in Chacabuco, Province of Buenos Aires, Argentina

Teaching and Research Committee

Alberto Quereda, Nuestra Señora del Carmen Hospital in Chacabuco, Province of Buenos Aires, Argentina

Teaching and Research Committee

Claudio González, Norberto Quirno University Institute Center for Medical Education and Clinical Research, City of Buenos Aires, Argentina

Department of Pharmacology

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Published

2025-06-16

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Vol. 59 No. 2 (2025): May-August

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Original article

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