The Effect of Diabetes Melitus and Blood Glucose on Patients Mortality with Severe COVID-19 Pneumonia Receiving Corticosteroids in RSUD Dr. Saiful Anwar Malang

Abstract

Background: Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). WHO has recommended the use of systemic corticosteroid therapy in patients with severe and critical COVID-19 pneumonia. However, the use of systemic corticosteroids is also a major contributor to hyperglycemia which is a strong prognostic predictor of poor outcome in hospitalized patients with COVID-19. Furthermore, diabetes mellitus (DM) is one of the most widely reported comorbidities in COVID-19 patients which affects the risk of morbidity and mortality and systemic corticosteroids can aggravate hyperglycemia in patients with this comorbidity.

Objective: This study aims to determine the effect of DM and blood glucose on mortality in patients with severe COVID-19 pneumonia who received corticosteroids.

Methods: The design of this study was an observational retrospective which was conducted on the medical records of COVID-19 patients who received convalescent plasma therapy at RSUD Dr. Saiful Anwar Malang (RSSA). Of the 229 patients who received convalescent plasma therapy and had fairly complete data, there were 85 patients with severe COVID-19 pneumonia who received corticosteroids with blood glucose data for analysis.

Results: There were significant differences in mortality rates in DM and non-DM patients (OR 3.091; CI 1.232-7.756; p=0.015) with severe COVID-19 pneumonia who received corticosteroids. Analysis of blood glucose levels shows that the mean random blood glucose (RBG) and initial RBG levels were higher in patients with a death outcome compared to those who lived (mean RBG 176.07 ± 72.0 mg/dl VS 133.23 ± 56.38 mg /dl, p=0.02; initial RBG 198.40 ± 127.13 mg/dl VS 141.57 ± 73.28 mg/dl, p=0.022.

Conclusion: DM and blood glucose levels (mean RBG and initial RBG) affect mortality rates in patients with severe COVID-19 pneumonia who are given corticosteroids.

Keywords: COVID-19, diabetes mellitus, blood glucose, corticosteroids

DOI: 10.7176/JHMN/102-07

Publication date:October 31^st 2022