SESSION TITLE: Critical Care Posters
SESSION TYPE: Original Investigation Posters
PRESENTED ON: October 18-21, 2020
PURPOSE: Diabetes has been shown in recent studies to be highly prevalent in critically ill patients with severe coronavirus disease 2019 (COVID-19). However, data comparing clinical outcomes in diabetic and non-diabetic patients remained limited. We aim to compare characteristics and clinical outcomes of diabetic and non-diabetic critically ill patients with severe COVID-19.
METHODS: Following institutional review board approval, we identified 115 patients who were admitted to the intensive care unit (ICU) for severe COVID-19. De-identified patient data was retrospectively collected and analyzed using Stata version 15.1 (StatCorp). Data reported here are those which are available through April 28 2020.
RESULTS: We identified 115 patients who were admitted to the ICU for severe COVID-19. The population had a mean age of 63.44 years, 67% were male, the mean BMI was 33.30. The mean duration of symptoms prior to hospitalization was 6.35 days. Comorbidities were common, 68 patients had a Charlson comorbidities index equal to or above 3. The most common comorbidities included hypertension (65%), diabetes (41%) and hyperlipidemia (35%). The most common symptoms were dyspnea (81%), cough (75%) and fever (68%). When comparing the 47 diabetic and the 68 non-diabetic patients in our study, there was a similar number of patients requiring invasive (65% diabetic; 51% non-diabetic) and non-invasive mechanical ventilation (36% diabetic; 48% non-diabetic). There were no significant differences in their clinical management. Both populations had similar rates of shock requiring vasopressors (57% diabetic; 48% non-diabetic) and renal failure requiring renal replacement therapy (27% diabetic; 25% non-diabetic). There were no significant differences in the rate of acute kidney injury (61% diabetics; 40% non-diabetics) and acute hepatic injury between both groups (27% diabetics; 22% non-diabetics). Diabetic patients had significantly higher rates of troponin elevation (89% diabetics; 70% non-diabetic). After propensity score matching, diabetics were more likely to experience in hospital mortality (OR 2.94 CI 1.32; 6.52, p-value 0.008) and were less likely to be discharged from the hospital (OR 0.38 CI 0.17; 0.83, p-value 0.02) when compared with non-diabetics.
CONCLUSIONS: Diabetics experience higher rates of mortality and are less likely to be discharged when compared with non-diabetic patients.
CLINICAL IMPLICATIONS: Further studies to evaluate management strategies in diabetic patients with severe COVID-19 may be useful given the increased risk for mortality in this population.
DISCLOSURES: No relevant relationships by Yasmin Herrera, source=Web Response
No relevant relationships by Kam Sing Ho, source=Web Response
No relevant relationships by Raymonde Jean, source=Web Response
No relevant relationships by Joseph Poon, source=Web Response
© 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.