Pneumonia ‘more common’ in people with diabetes and COVID-19

People with diabetes who test positive for COVID-19 could be at a higher risk of developing pneumonia, researchers have said.

A study carried out in Wuhan, where the original coronavirus outbreak started, showed that people with diabetes were more likely to develop inflammatory storm leading to rapid deterioration in COVID-19 when compared with adults without diabetes who contracted the killer virus.

Lead researcher Professor Desheng Hu, professor in the department of integrated traditional Chinese and western medicine at Tongji Medical College, Huazhong University of Science and Technology in Wuhan, said: “Common perceptions associate diabetes with a generally increased mortality and morbidity to infectious diseases, although epidemiologic data that would prove this are surprisingly scarce.

‘Infection and death’

“However, it seems to be confirmed that diabetes predisposes to certain types of infection and death, but it is still unknown whether diabetes is a risk factor for the prognosis of COVID-19.”

Professor Hu analysed data from 174 people with confirmed COVID-19, who were admitted to Wuhan Union Hospital between February 10 and 29. They took into account all their medical history, symptoms, laboratory findings, chest CT and treatment measures (mean age, 59 years; 43.7% men).

Diabetes might be considered as a risk factor for the outcome of SARS-CoV-2 pneumonia, and more intensive attention should be paid to patients with diabetes, in case of rapid deterioration

Professor Hu said: “We divided all patients into two groups based on whether they had diabetes. In the second part, we excluded patients with comorbidities other than diabetes to avoid the impact of other comorbidities, and then the patients with diabetes and patients without diabetes were separated into two groups.”

Within the cohort, the most common symptoms were fever (78.2%), chill (68.4%), cough (32.2%), fatigue (27%), chest tightness (25.9%), shortness of breath (24.1%) and myalgia (20.7%). More rare were symptoms of nausea (9.8%), headache (6.9%), pharyngalgia (5.2%) and chest pain (8.6%). The most common comorbidities were hypertension (24.7%) and diabetes (21.2%).

Researchers found that those with COVID-19 and diabetes, but no other comorbidities (n = 24), were at higher risk for severe pneumonia, release of tissue injury-related enzymes, excessive uncontrolled inflammation responses and hypercoagulable state associated with dysregulation of glucose metabolism when compared with patients without diabetes.

Additionally, CT chest images from patients with COVID-19 and diabetes showed more severe pathological changes vs. those with COVID-19 but no diabetes.

The researchers concluded: “All in all, whether interference from other comorbidities is present or not, we found that SARS-CoV-2 pneumonia patients with diabetes are more severe than those without diabetes evaluating from organ damage, inflammatory factors or hypercoagulability, and are more likely to progress into a worse prognosis.

“Therefore, diabetes might be considered as a risk factor for the outcome of SARS-CoV-2 pneumonia, and more intensive attention should be paid to patients with diabetes, in case of rapid deterioration.”

The research has been published in the Diabetes Metabolism Research and Review.

Picture credit: Vincent Ghilione