Clinical characteristics of patients with COVID-19 depending on the treatment received and the presence of type 2 diabetes mellitus

BACKGROUND.   Type 2 diabetes mellitus (T2DM) is an independent risk factor for adverse clinical outcomes in patients with Covid-19. There is currently insufficient data evaluating the efficacy and safety of drugs for the treatment of COVID-19, especially in patients with T2DM. AIM.   The aim of study was to identify an associative relationship between the drugs used and the clinical outcomes of patients with Covid-19 and T2DM. MATERIALS AND METHODS.   A retrospective analysis of the clinical outcomes of 1753 patients with COVID-19 who were hospitalized to the redesignated departments of multidisciplinary city clinical hospital in the period from 23.03.2020 to 01.06.2020. RESULTS.  The total number of patients is 1,753, of which 311 (17.7%) are patients with DM2. 92.6% of patients received treatment for COVID-19. At the same time, 91.4% of patients received antibiotics (a/b), 61.5% — bronchodilators, 56.6% — injectable anticoagulants (a/c), 45.2% — hydroxychloroquine, 6.3% — antiviral drugs, 5.4% — oral a/c, 4.6% — glucocorticosteroids (GCS), 1.9% — Tocilizumab. Decrease of risk of death among patients with COVID-19 was as the therapy of a/b (OR 0.07, 95% CI 0.05–0.11, p<0.05), bronchodilators (OR 0.12, 95% CI 0.08–0.18, p<0.05) and injection a/c (OR 0.47, 95% CI 0.34–0.67, p<0.05). At the same time, among patients with DM2, compared with patients without DM2, there was a more pronounced reduction in the risk of death during injectable a/c therapy: among patients with DM2, the risk of death decreased by 2.6 times (OR 0.39, 95% CI 0.21–0.73, p<0.05), among patients without DM2 — by 2.1 times (OR 0.47, 95% CI 0.31–0.71, p<0.05). Antiviral drugs was associated with an increased chance of death among patients without DM2 (OR 2.64, 95% CI 1.44–4.86, p<0.05) and among patients with DM2 (OR 4.98, 95% CI 2.11–11.75, p<0.05). CONCLUSION.   A significant decrease of the risk of death among patients with COVID-19 was as the therapy of a/b, bronchodilators, and injectable a/c. An increase of the risk of death was observed during therapy with antiviral drugs.