High Prevalence of Diabetes Among Hospitalized COVID-19 Minority Patients: Data from a Single Tertiary Hospital
Background and Aim Type 2 diabetes mellitus (DM) is a common comorbidity in the minority population and is associated with poor outcomes in COVID-19 patients. We hypothesized that COVID-19 patients with pre-existing diabetes mellitus are prone to fatal outcomes compared to non-diabetic patients. We...
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| Veröffentlicht in: | Journal of racial and ethnic health disparities 2024-08, Vol.11 (4), p.2488-2497 |
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| creator | Ashktorab, Hassan Oskrochi, Gholamreza Challa, Suryanarayana Reddy Chirumamilla, Lakshmi G. Ahangarzadeh, Faezeh Jones-Wonni, Boubini Shayegh, Nader Rashid, Mudasir Naqvi, Zainab Ekpe, Elizabeth Sabyasachi, Sen Zenebe, Anteneh Brim, Hassan |
| description | Background and Aim
Type 2 diabetes mellitus (DM) is a common comorbidity in the minority population and is associated with poor outcomes in COVID-19 patients. We hypothesized that COVID-19 patients with pre-existing diabetes mellitus are prone to fatal outcomes compared to non-diabetic patients. We aimed to illustrate the characteristics and outcomes and identify the risk factors for in-hospital mortality of COVID-19 patients with DM.
Methods
In this single-center retrospective study, electronic medical records of hospitalized patients with confirmed COVID-19 diagnosis at Howard University Hospital (HUH) from March 2020 to Dec 2021 were analyzed. Clinical, demographic, and serological information, as well as outcomes, were recorded and analyzed.
Results
Among 463 COVID-19 patients, 66.3% (
n
= 307) were African Americans (AA) and 35.9% (
n
= 166) had diabetes, with a mean age of 64 years. The majority of the diabetic patients were AA (
n
= 123, 74.1%) and had a higher mortality rate (
n
= 26, 74.3%) compared to others. Length of stay in the hospital is significantly more for the diabetic than for the non-diabetic patients (11.3 vs. 8.3 days,
p
= 0.03). A higher proportion of ICU admission (32.3% vs. 17.9%,
p
= |
| doi_str_mv | 10.1007/s40615-023-01714-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2847747141</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3078234139</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-6c589b7522e59a975e718dd2d02d0aa66a20305986a1bfb855f40838436cd0ca3</originalsourceid><addsrcrecordid>eNp9kV9rFDEUxYMottR-AR8k4Isv0Ztk8md8K7vqFiotWH0NmZk7a8rMZE2yhfrpjd1awQchkEB-99x7zyHkJYe3HMC8yw1orhgIyYAb3jDxhBwL3mpmrTRP79-GSdOKI3Ka8w0AcKFUK_VzciSNArASjknchO13epXw1k-49EjjSNfBd1gw07M5Llu6iXkXip_CTxzo6vLb-Zrxln4OS0yh3NErXwIuJb-na188HVOcqadfwrKdkF5jKsGnu0eRF-TZ6KeMpw_3Cfn68cP1asMuLj-dr84uWC-FLkz3yradUUKgan1rFBpuh0EMUI_3WnsBElRrtefd2FmlxqYuZBup-wF6L0_Im4PuLsUfe8zFzSH3OE1-wbjPTtjGmKb6xiv6-h_0Ju7TUqdzEowVsjJtpcSB6lPMOeHodinMdTXHwf1OxB0ScTURd5-IE7Xo1YP0vptxeCz5438F5AHI9WvZYvrb-z-yvwCTpZPX</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3078234139</pqid></control><display><type>article</type><title>High Prevalence of Diabetes Among Hospitalized COVID-19 Minority Patients: Data from a Single Tertiary Hospital</title><source>MEDLINE</source><source>SpringerNature Journals</source><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><creator>Ashktorab, Hassan ; Oskrochi, Gholamreza ; Challa, Suryanarayana Reddy ; Chirumamilla, Lakshmi G. ; Ahangarzadeh, Faezeh ; Jones-Wonni, Boubini ; Shayegh, Nader ; Rashid, Mudasir ; Naqvi, Zainab ; Ekpe, Elizabeth ; Sabyasachi, Sen ; Zenebe, Anteneh ; Brim, Hassan</creator><creatorcontrib>Ashktorab, Hassan ; Oskrochi, Gholamreza ; Challa, Suryanarayana Reddy ; Chirumamilla, Lakshmi G. ; Ahangarzadeh, Faezeh ; Jones-Wonni, Boubini ; Shayegh, Nader ; Rashid, Mudasir ; Naqvi, Zainab ; Ekpe, Elizabeth ; Sabyasachi, Sen ; Zenebe, Anteneh ; Brim, Hassan</creatorcontrib><description>Background and Aim
Type 2 diabetes mellitus (DM) is a common comorbidity in the minority population and is associated with poor outcomes in COVID-19 patients. We hypothesized that COVID-19 patients with pre-existing diabetes mellitus are prone to fatal outcomes compared to non-diabetic patients. We aimed to illustrate the characteristics and outcomes and identify the risk factors for in-hospital mortality of COVID-19 patients with DM.
Methods
In this single-center retrospective study, electronic medical records of hospitalized patients with confirmed COVID-19 diagnosis at Howard University Hospital (HUH) from March 2020 to Dec 2021 were analyzed. Clinical, demographic, and serological information, as well as outcomes, were recorded and analyzed.
Results
Among 463 COVID-19 patients, 66.3% (
n
= 307) were African Americans (AA) and 35.9% (
n
= 166) had diabetes, with a mean age of 64 years. The majority of the diabetic patients were AA (
n
= 123, 74.1%) and had a higher mortality rate (
n
= 26, 74.3%) compared to others. Length of stay in the hospital is significantly more for the diabetic than for the non-diabetic patients (11.3 vs. 8.3 days,
p
= 0.03). A higher proportion of ICU admission (32.3% vs. 17.9%,
p
= < 0.001), intubation (17% vs. 11.7%,
p
= 0.04), and increased mortality (21.1% vs. 12.2%,
p
= 0.01) were identified in COVID-19 patients with DM than in those with no DM. Among DM patients, non-survivors were older (69.9 vs. 62.9 years). DM patients were more likely to have underlying hypertension (72.3% vs. 43.3%,
p
= < 0.001), obesity (44.8% vs. 32.1%,
p
= 0.007), chronic kidney disease (23.6 vs. 11.8%,
p
= 0.001), and cardiovascular disease (29.5% vs. 14.3%,
p
= 0.001) than the non-DM patients. HbA1C above 9%, indicating poorly controlled hyperglycemia, was associated with poor outcome among the DM subjects. AST (23.5% vs. 31.3%) and creatinine (61.4% vs. 37.9%) were significantly more elevated in DM COVID-19 patients (all
p
-values < 0.05). The levels of serum troponin (42.5% vs. 30.9%,
p
= 0.03), interleukin-6 (67.2 vs. 50%,
p
= 0.04), ferritin (65.6% vs. 44.6%,
p
= 0.03), procalcitonin (58.1% vs. 46.1,
p
= 0.03), and D-dimers (92.8% vs. 86.5%,
p
= 0.04) were significantly higher in DM patients as compared to those in non-DM COVID-19 patients, indicating more susceptibility of diabetic COVID-19 patients to coagulation dysfunction and inflammatory storm.
Conclusion
The prevalence of DM is high among hospitalized COVID-19 patients in our cohort. While DM patients have a higher mortality rate and ICU admission than non-DM patients, other factors such as underlying comorbidities, old age, elevated creatinine, AST, serum inflammatory markers, and D-dimer are more significant predictors of fatal outcomes. DM patients had higher metabolic derangements, hypercoagulability, and severe inflammatory response. No significant difference of outcome was noted between DM patients of different races in our cohort. In the diabetic group, it appears that race may not significantly contribute to the observed mortality disparity. This could be attributed to the significant influence of diabetes, which acts as a major effector, potentially overshadowing the significance of race in this context.</description><identifier>ISSN: 2197-3792</identifier><identifier>ISSN: 2196-8837</identifier><identifier>EISSN: 2196-8837</identifier><identifier>DOI: 10.1007/s40615-023-01714-2</identifier><identifier>PMID: 37500830</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adult ; African Americans ; Aged ; Aged, 80 and over ; Black or African American - statistics & numerical data ; Cardiovascular diseases ; Coagulation ; Comorbidity ; Computerized medical records ; COVID-19 ; COVID-19 - epidemiology ; COVID-19 - ethnology ; COVID-19 - mortality ; Creatinine ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - epidemiology ; Diabetes Mellitus, Type 2 - ethnology ; Diabetes Mellitus, Type 2 - mortality ; Dimers ; Electronic health records ; Electronic medical records ; Epidemiology ; Female ; Ferritin ; Hospital Mortality ; Hospitalization ; Hospitalization - statistics & numerical data ; Hospitals ; Humans ; Hyperglycemia ; Hypertension ; Inflammation ; Inflammatory response ; Intensive care ; Interleukin 6 ; Kidney diseases ; Length of stay ; Male ; Mechanical ventilation ; Medical diagnosis ; Medical records ; Medicine ; Medicine & Public Health ; Middle Aged ; Minority groups ; Minority Groups - statistics & numerical data ; Mortality ; Mortality rates ; Obesity ; Patient admissions ; Patients ; Prevalence ; Procalcitonin ; Quality of Life Research ; Race ; Retrospective Studies ; Risk Factors ; Serum ; Social Inequality ; Social Structure ; Susceptibility ; Tertiary Care Centers - statistics & numerical data ; Troponin ; Type 2 diabetes mellitus</subject><ispartof>Journal of racial and ethnic health disparities, 2024-08, Vol.11 (4), p.2488-2497</ispartof><rights>W. Montague Cobb-NMA Health Institute 2023. corrected publication 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. W. Montague Cobb-NMA Health Institute.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-6c589b7522e59a975e718dd2d02d0aa66a20305986a1bfb855f40838436cd0ca3</cites><orcidid>0000-0002-4048-4666</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40615-023-01714-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s40615-023-01714-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,30999,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37500830$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ashktorab, Hassan</creatorcontrib><creatorcontrib>Oskrochi, Gholamreza</creatorcontrib><creatorcontrib>Challa, Suryanarayana Reddy</creatorcontrib><creatorcontrib>Chirumamilla, Lakshmi G.</creatorcontrib><creatorcontrib>Ahangarzadeh, Faezeh</creatorcontrib><creatorcontrib>Jones-Wonni, Boubini</creatorcontrib><creatorcontrib>Shayegh, Nader</creatorcontrib><creatorcontrib>Rashid, Mudasir</creatorcontrib><creatorcontrib>Naqvi, Zainab</creatorcontrib><creatorcontrib>Ekpe, Elizabeth</creatorcontrib><creatorcontrib>Sabyasachi, Sen</creatorcontrib><creatorcontrib>Zenebe, Anteneh</creatorcontrib><creatorcontrib>Brim, Hassan</creatorcontrib><title>High Prevalence of Diabetes Among Hospitalized COVID-19 Minority Patients: Data from a Single Tertiary Hospital</title><title>Journal of racial and ethnic health disparities</title><addtitle>J. Racial and Ethnic Health Disparities</addtitle><addtitle>J Racial Ethn Health Disparities</addtitle><description>Background and Aim
Type 2 diabetes mellitus (DM) is a common comorbidity in the minority population and is associated with poor outcomes in COVID-19 patients. We hypothesized that COVID-19 patients with pre-existing diabetes mellitus are prone to fatal outcomes compared to non-diabetic patients. We aimed to illustrate the characteristics and outcomes and identify the risk factors for in-hospital mortality of COVID-19 patients with DM.
Methods
In this single-center retrospective study, electronic medical records of hospitalized patients with confirmed COVID-19 diagnosis at Howard University Hospital (HUH) from March 2020 to Dec 2021 were analyzed. Clinical, demographic, and serological information, as well as outcomes, were recorded and analyzed.
Results
Among 463 COVID-19 patients, 66.3% (
n
= 307) were African Americans (AA) and 35.9% (
n
= 166) had diabetes, with a mean age of 64 years. The majority of the diabetic patients were AA (
n
= 123, 74.1%) and had a higher mortality rate (
n
= 26, 74.3%) compared to others. Length of stay in the hospital is significantly more for the diabetic than for the non-diabetic patients (11.3 vs. 8.3 days,
p
= 0.03). A higher proportion of ICU admission (32.3% vs. 17.9%,
p
= < 0.001), intubation (17% vs. 11.7%,
p
= 0.04), and increased mortality (21.1% vs. 12.2%,
p
= 0.01) were identified in COVID-19 patients with DM than in those with no DM. Among DM patients, non-survivors were older (69.9 vs. 62.9 years). DM patients were more likely to have underlying hypertension (72.3% vs. 43.3%,
p
= < 0.001), obesity (44.8% vs. 32.1%,
p
= 0.007), chronic kidney disease (23.6 vs. 11.8%,
p
= 0.001), and cardiovascular disease (29.5% vs. 14.3%,
p
= 0.001) than the non-DM patients. HbA1C above 9%, indicating poorly controlled hyperglycemia, was associated with poor outcome among the DM subjects. AST (23.5% vs. 31.3%) and creatinine (61.4% vs. 37.9%) were significantly more elevated in DM COVID-19 patients (all
p
-values < 0.05). The levels of serum troponin (42.5% vs. 30.9%,
p
= 0.03), interleukin-6 (67.2 vs. 50%,
p
= 0.04), ferritin (65.6% vs. 44.6%,
p
= 0.03), procalcitonin (58.1% vs. 46.1,
p
= 0.03), and D-dimers (92.8% vs. 86.5%,
p
= 0.04) were significantly higher in DM patients as compared to those in non-DM COVID-19 patients, indicating more susceptibility of diabetic COVID-19 patients to coagulation dysfunction and inflammatory storm.
Conclusion
The prevalence of DM is high among hospitalized COVID-19 patients in our cohort. While DM patients have a higher mortality rate and ICU admission than non-DM patients, other factors such as underlying comorbidities, old age, elevated creatinine, AST, serum inflammatory markers, and D-dimer are more significant predictors of fatal outcomes. DM patients had higher metabolic derangements, hypercoagulability, and severe inflammatory response. No significant difference of outcome was noted between DM patients of different races in our cohort. In the diabetic group, it appears that race may not significantly contribute to the observed mortality disparity. This could be attributed to the significant influence of diabetes, which acts as a major effector, potentially overshadowing the significance of race in this context.</description><subject>Adult</subject><subject>African Americans</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Black or African American - statistics & numerical data</subject><subject>Cardiovascular diseases</subject><subject>Coagulation</subject><subject>Comorbidity</subject><subject>Computerized medical records</subject><subject>COVID-19</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - ethnology</subject><subject>COVID-19 - mortality</subject><subject>Creatinine</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Diabetes Mellitus, Type 2 - ethnology</subject><subject>Diabetes Mellitus, Type 2 - mortality</subject><subject>Dimers</subject><subject>Electronic health records</subject><subject>Electronic medical records</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Ferritin</subject><subject>Hospital Mortality</subject><subject>Hospitalization</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hyperglycemia</subject><subject>Hypertension</subject><subject>Inflammation</subject><subject>Inflammatory response</subject><subject>Intensive care</subject><subject>Interleukin 6</subject><subject>Kidney diseases</subject><subject>Length of stay</subject><subject>Male</subject><subject>Mechanical ventilation</subject><subject>Medical diagnosis</subject><subject>Medical records</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Minority groups</subject><subject>Minority Groups - statistics & numerical data</subject><subject>Mortality</subject><subject>Mortality rates</subject><subject>Obesity</subject><subject>Patient admissions</subject><subject>Patients</subject><subject>Prevalence</subject><subject>Procalcitonin</subject><subject>Quality of Life Research</subject><subject>Race</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Serum</subject><subject>Social Inequality</subject><subject>Social Structure</subject><subject>Susceptibility</subject><subject>Tertiary Care Centers - statistics & numerical data</subject><subject>Troponin</subject><subject>Type 2 diabetes mellitus</subject><issn>2197-3792</issn><issn>2196-8837</issn><issn>2196-8837</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNp9kV9rFDEUxYMottR-AR8k4Isv0Ztk8md8K7vqFiotWH0NmZk7a8rMZE2yhfrpjd1awQchkEB-99x7zyHkJYe3HMC8yw1orhgIyYAb3jDxhBwL3mpmrTRP79-GSdOKI3Ka8w0AcKFUK_VzciSNArASjknchO13epXw1k-49EjjSNfBd1gw07M5Llu6iXkXip_CTxzo6vLb-Zrxln4OS0yh3NErXwIuJb-na188HVOcqadfwrKdkF5jKsGnu0eRF-TZ6KeMpw_3Cfn68cP1asMuLj-dr84uWC-FLkz3yradUUKgan1rFBpuh0EMUI_3WnsBElRrtefd2FmlxqYuZBup-wF6L0_Im4PuLsUfe8zFzSH3OE1-wbjPTtjGmKb6xiv6-h_0Ju7TUqdzEowVsjJtpcSB6lPMOeHodinMdTXHwf1OxB0ScTURd5-IE7Xo1YP0vptxeCz5438F5AHI9WvZYvrb-z-yvwCTpZPX</recordid><startdate>20240801</startdate><enddate>20240801</enddate><creator>Ashktorab, Hassan</creator><creator>Oskrochi, Gholamreza</creator><creator>Challa, Suryanarayana Reddy</creator><creator>Chirumamilla, Lakshmi G.</creator><creator>Ahangarzadeh, Faezeh</creator><creator>Jones-Wonni, Boubini</creator><creator>Shayegh, Nader</creator><creator>Rashid, Mudasir</creator><creator>Naqvi, Zainab</creator><creator>Ekpe, Elizabeth</creator><creator>Sabyasachi, Sen</creator><creator>Zenebe, Anteneh</creator><creator>Brim, Hassan</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4048-4666</orcidid></search><sort><creationdate>20240801</creationdate><title>High Prevalence of Diabetes Among Hospitalized COVID-19 Minority Patients: Data from a Single Tertiary Hospital</title><author>Ashktorab, Hassan ; Oskrochi, Gholamreza ; Challa, Suryanarayana Reddy ; Chirumamilla, Lakshmi G. ; Ahangarzadeh, Faezeh ; Jones-Wonni, Boubini ; Shayegh, Nader ; Rashid, Mudasir ; Naqvi, Zainab ; Ekpe, Elizabeth ; Sabyasachi, Sen ; Zenebe, Anteneh ; Brim, Hassan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-6c589b7522e59a975e718dd2d02d0aa66a20305986a1bfb855f40838436cd0ca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>African Americans</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Black or African American - statistics & numerical data</topic><topic>Cardiovascular diseases</topic><topic>Coagulation</topic><topic>Comorbidity</topic><topic>Computerized medical records</topic><topic>COVID-19</topic><topic>COVID-19 - epidemiology</topic><topic>COVID-19 - ethnology</topic><topic>COVID-19 - mortality</topic><topic>Creatinine</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Diabetes Mellitus, Type 2 - ethnology</topic><topic>Diabetes Mellitus, Type 2 - mortality</topic><topic>Dimers</topic><topic>Electronic health records</topic><topic>Electronic medical records</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Ferritin</topic><topic>Hospital Mortality</topic><topic>Hospitalization</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hyperglycemia</topic><topic>Hypertension</topic><topic>Inflammation</topic><topic>Inflammatory response</topic><topic>Intensive care</topic><topic>Interleukin 6</topic><topic>Kidney diseases</topic><topic>Length of stay</topic><topic>Male</topic><topic>Mechanical ventilation</topic><topic>Medical diagnosis</topic><topic>Medical records</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Minority groups</topic><topic>Minority Groups - statistics & numerical data</topic><topic>Mortality</topic><topic>Mortality rates</topic><topic>Obesity</topic><topic>Patient admissions</topic><topic>Patients</topic><topic>Prevalence</topic><topic>Procalcitonin</topic><topic>Quality of Life Research</topic><topic>Race</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Serum</topic><topic>Social Inequality</topic><topic>Social Structure</topic><topic>Susceptibility</topic><topic>Tertiary Care Centers - statistics & numerical data</topic><topic>Troponin</topic><topic>Type 2 diabetes mellitus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ashktorab, Hassan</creatorcontrib><creatorcontrib>Oskrochi, Gholamreza</creatorcontrib><creatorcontrib>Challa, Suryanarayana Reddy</creatorcontrib><creatorcontrib>Chirumamilla, Lakshmi G.</creatorcontrib><creatorcontrib>Ahangarzadeh, Faezeh</creatorcontrib><creatorcontrib>Jones-Wonni, Boubini</creatorcontrib><creatorcontrib>Shayegh, Nader</creatorcontrib><creatorcontrib>Rashid, Mudasir</creatorcontrib><creatorcontrib>Naqvi, Zainab</creatorcontrib><creatorcontrib>Ekpe, Elizabeth</creatorcontrib><creatorcontrib>Sabyasachi, Sen</creatorcontrib><creatorcontrib>Zenebe, Anteneh</creatorcontrib><creatorcontrib>Brim, Hassan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of racial and ethnic health disparities</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ashktorab, Hassan</au><au>Oskrochi, Gholamreza</au><au>Challa, Suryanarayana Reddy</au><au>Chirumamilla, Lakshmi G.</au><au>Ahangarzadeh, Faezeh</au><au>Jones-Wonni, Boubini</au><au>Shayegh, Nader</au><au>Rashid, Mudasir</au><au>Naqvi, Zainab</au><au>Ekpe, Elizabeth</au><au>Sabyasachi, Sen</au><au>Zenebe, Anteneh</au><au>Brim, Hassan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High Prevalence of Diabetes Among Hospitalized COVID-19 Minority Patients: Data from a Single Tertiary Hospital</atitle><jtitle>Journal of racial and ethnic health disparities</jtitle><stitle>J. Racial and Ethnic Health Disparities</stitle><addtitle>J Racial Ethn Health Disparities</addtitle><date>2024-08-01</date><risdate>2024</risdate><volume>11</volume><issue>4</issue><spage>2488</spage><epage>2497</epage><pages>2488-2497</pages><issn>2197-3792</issn><issn>2196-8837</issn><eissn>2196-8837</eissn><abstract>Background and Aim
Type 2 diabetes mellitus (DM) is a common comorbidity in the minority population and is associated with poor outcomes in COVID-19 patients. We hypothesized that COVID-19 patients with pre-existing diabetes mellitus are prone to fatal outcomes compared to non-diabetic patients. We aimed to illustrate the characteristics and outcomes and identify the risk factors for in-hospital mortality of COVID-19 patients with DM.
Methods
In this single-center retrospective study, electronic medical records of hospitalized patients with confirmed COVID-19 diagnosis at Howard University Hospital (HUH) from March 2020 to Dec 2021 were analyzed. Clinical, demographic, and serological information, as well as outcomes, were recorded and analyzed.
Results
Among 463 COVID-19 patients, 66.3% (
n
= 307) were African Americans (AA) and 35.9% (
n
= 166) had diabetes, with a mean age of 64 years. The majority of the diabetic patients were AA (
n
= 123, 74.1%) and had a higher mortality rate (
n
= 26, 74.3%) compared to others. Length of stay in the hospital is significantly more for the diabetic than for the non-diabetic patients (11.3 vs. 8.3 days,
p
= 0.03). A higher proportion of ICU admission (32.3% vs. 17.9%,
p
= < 0.001), intubation (17% vs. 11.7%,
p
= 0.04), and increased mortality (21.1% vs. 12.2%,
p
= 0.01) were identified in COVID-19 patients with DM than in those with no DM. Among DM patients, non-survivors were older (69.9 vs. 62.9 years). DM patients were more likely to have underlying hypertension (72.3% vs. 43.3%,
p
= < 0.001), obesity (44.8% vs. 32.1%,
p
= 0.007), chronic kidney disease (23.6 vs. 11.8%,
p
= 0.001), and cardiovascular disease (29.5% vs. 14.3%,
p
= 0.001) than the non-DM patients. HbA1C above 9%, indicating poorly controlled hyperglycemia, was associated with poor outcome among the DM subjects. AST (23.5% vs. 31.3%) and creatinine (61.4% vs. 37.9%) were significantly more elevated in DM COVID-19 patients (all
p
-values < 0.05). The levels of serum troponin (42.5% vs. 30.9%,
p
= 0.03), interleukin-6 (67.2 vs. 50%,
p
= 0.04), ferritin (65.6% vs. 44.6%,
p
= 0.03), procalcitonin (58.1% vs. 46.1,
p
= 0.03), and D-dimers (92.8% vs. 86.5%,
p
= 0.04) were significantly higher in DM patients as compared to those in non-DM COVID-19 patients, indicating more susceptibility of diabetic COVID-19 patients to coagulation dysfunction and inflammatory storm.
Conclusion
The prevalence of DM is high among hospitalized COVID-19 patients in our cohort. While DM patients have a higher mortality rate and ICU admission than non-DM patients, other factors such as underlying comorbidities, old age, elevated creatinine, AST, serum inflammatory markers, and D-dimer are more significant predictors of fatal outcomes. DM patients had higher metabolic derangements, hypercoagulability, and severe inflammatory response. No significant difference of outcome was noted between DM patients of different races in our cohort. In the diabetic group, it appears that race may not significantly contribute to the observed mortality disparity. This could be attributed to the significant influence of diabetes, which acts as a major effector, potentially overshadowing the significance of race in this context.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>37500830</pmid><doi>10.1007/s40615-023-01714-2</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-4048-4666</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2197-3792 |
| ispartof | Journal of racial and ethnic health disparities, 2024-08, Vol.11 (4), p.2488-2497 |
| issn | 2197-3792 2196-8837 2196-8837 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2847747141 |
| source | MEDLINE; SpringerNature Journals; Applied Social Sciences Index & Abstracts (ASSIA) |
| subjects | Adult African Americans Aged Aged, 80 and over Black or African American - statistics & numerical data Cardiovascular diseases Coagulation Comorbidity Computerized medical records COVID-19 COVID-19 - epidemiology COVID-19 - ethnology COVID-19 - mortality Creatinine Diabetes Diabetes mellitus Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - epidemiology Diabetes Mellitus, Type 2 - ethnology Diabetes Mellitus, Type 2 - mortality Dimers Electronic health records Electronic medical records Epidemiology Female Ferritin Hospital Mortality Hospitalization Hospitalization - statistics & numerical data Hospitals Humans Hyperglycemia Hypertension Inflammation Inflammatory response Intensive care Interleukin 6 Kidney diseases Length of stay Male Mechanical ventilation Medical diagnosis Medical records Medicine Medicine & Public Health Middle Aged Minority groups Minority Groups - statistics & numerical data Mortality Mortality rates Obesity Patient admissions Patients Prevalence Procalcitonin Quality of Life Research Race Retrospective Studies Risk Factors Serum Social Inequality Social Structure Susceptibility Tertiary Care Centers - statistics & numerical data Troponin Type 2 diabetes mellitus |
| title | High Prevalence of Diabetes Among Hospitalized COVID-19 Minority Patients: Data from a Single Tertiary Hospital |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-21T06%3A05%3A20IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=High%20Prevalence%20of%20Diabetes%20Among%20Hospitalized%20COVID-19%20Minority%20Patients:%20Data%20from%20a%20Single%20Tertiary%20Hospital&rft.jtitle=Journal%20of%20racial%20and%20ethnic%20health%20disparities&rft.au=Ashktorab,%20Hassan&rft.date=2024-08-01&rft.volume=11&rft.issue=4&rft.spage=2488&rft.epage=2497&rft.pages=2488-2497&rft.issn=2197-3792&rft.eissn=2196-8837&rft_id=info:doi/10.1007/s40615-023-01714-2&rft_dat=%3Cproquest_cross%3E3078234139%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3078234139&rft_id=info:pmid/37500830&rfr_iscdi=true |