Prevalence, Risk Factors, and Outcome of Diabetic Patients Infected with COVID-19 in Saudi Arabia

Background: Recent global studies including those coming from Saudi Arabia highlighted the apparent increase in the prevalence and severity of COVID-19 in diabetic patients. Hence, this study was conducted to report the prevalence, clinical outcomes, and risk factors among a cohort of diabetic patients with COVID-19 infection in Saudi Arabia. Research Design and Methods: A retrospective observational case–control study of COVID-19 patients admitted at two major hospitals in Saudi Arabia between April 2020 and July 2020. Electronic charts were retrospectively reviewed, comparing diabetic and nondiabetic patients' demographic, clinical variables, and outcome measures. Results: A total of 564 patients with polymerase chain reaction-confirmed COVID-19 infection were enrolled in the study. Their mean age was 52.3 ± 14.4 years and 254 patients (45%) had diabetes mellitus (DM). Diabetic patients were significantly older compared to patients without DM (P < 0.001) and more likely to have hypertension (P < 0.001), heart failure (P = 0.011), chronic kidney disease (P = 0.002), ischemic heart disease (P = 0.005), and higher D-Dimer level (P = 0.011). Patients with DM had significantly higher risk of acute kidney injury (26.4% vs. 14.8%, P = 0.001) and higher rate of inhospital mortality (25.2% vs. 15.8%, P = 0.006) compared to nondiabetics. The most important independent risk factors in diabetic patients were HbA1c and the average capillary glucose check during admission (P < 0.001). Conclusion: Diabetes is highly prevalent among COVID-19 patients admitted to hospitals in Saudi Arabia. The inhospital mortality rate is increased among diabetic patients of older age group with high HbA1c levels, poor glycemic control during hospitalization, and had multiple comorbid conditions compared to nondiabetics. Early identification of at-risk patients with DM and optimal blood glucose control are extremely important for better clinical outcomes.