Analysis of the prognostic quality of mortality predictors in patients with COVID-19 and comorbid background: a retrospective study

Objective: Analysis of the impact of diabetes mellitus on the course and outcome of COVID-19 in a sample of hospitalized patients with the identification of key factors that worsen the prognosis of the disease.

Material and methods: A retrospective study of 645 medical records of patients with confirmed COVID-19 was conducted. Participants were grouped based on the outcome of hospitalization (fatal outcome/recovery) and the presence of type 2 diabetes mellitus. Clinical and anamnestic data, a number of laboratory and instrumental indicators, and hospitalization outcomes were assessed. ROC analysis was performed to assess the prognostic quality of the indicators.

Results: Age and gender turned out to be important factors influencing mortality: patients with a fatal outcome were significantly older (p<0.001), and men died more often (40% of cases, p<0.001). The expected relationship between the increase in blood glucose levels and worsening outcomes was also revealed: according to the results of the ROC analysis, an unfavorable outcome was predicted at a venous blood glucose level of more than 7.1 mmol / l. Patients with diabetes mellitus were often found to have comorbid conditions, such as arterial hypertension (82.2%) and coronary artery disease (20%), which worsened the prognosis. The mortality rate of patients with severe comorbid status was 2 times higher compared to patients with only one concomitant pathology.

Conclusion: The results of the analysis confirmed the need for a comprehensive approach to the management of patients with COVID-19 in the group of patients with severe comorbid status. In order to improve the prognosis for COVID-19 infection in patients with type 2 diabetes mellitus, strict monitoring and compensation of all comorbidities should be carried out, and the patient’s age and gender should be taken into account when choosing a treatment strategy.