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. 2021 Nov 23:2021:1676914.
doi: 10.1155/2021/1676914. eCollection 2021.

Factors Affecting the Incidence, Progression, and Severity of COVID-19 in Type 1 Diabetes Mellitus

Amira S Ahmed  1   2 , Wejdan S Alotaibi  3 , Maha A Aldubayan  1 , Ahmad H Alhowail  1 , Amal H Al-Najjar  4 , Sridevi Chigurupati  5 , Rehab M Elgharabawy  1   6
Affiliations

Factors Affecting the Incidence, Progression, and Severity of COVID-19 in Type 1 Diabetes Mellitus

Amira S Ahmed et al. Biomed Res Int. .

Abstract

Objectives: This study screened for factors affecting coronavirus disease 2019 (COVID-19) incidence in type 1 diabetes mellitus (T1DM) patients, appraised vitamin D's efficacy in preventing COVID-19, and assessed the effects of clinical characteristics, glycemic status, vitamin D, and hydroxychloroquine administration on COVID-19's progression and severity in T1DM patients.

Methods: This retrospective research on 150 adults was conducted at Security Forces Hospital, Riyadh, KSA. Participants were allocated to three groups (50/group): control, T1DM, and T1DM with COVID-19. Participants' fasting blood glucose (FBG), glycated hemoglobin (HbA1c), complete blood count, vitamin D, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), ferritin, lactate dehydrogenase (LDH), prothrombin time, activated partial thromboplastin time, D-dimer, liver and kidney function, and hydroxychloroquine treatment were retrieved and analyzed.

Results: The percentages of comorbidities and not taking hydroxychloroquine were significantly higher among T1DM patients with COVID-19 than patients with T1DM only. Mean vitamin D level was significantly lower in T1DM with COVID-19 patients than in the other two groups. Vitamin D showed a significant negative correlation with LDH, CRP, ESR, ferritin, and D-dimer, which was the most reliable predictor of COVID-19 severity in T1DM patients.

Conclusion: Comorbidities and vitamin D deficiency are risk factors for COVID-19 in patients with T1DM. Patients who do not take hydroxychloroquine and have higher FBG and HbA1c levels are vulnerable to COVID-19. Vitamin D may be useful for preventing COVID-19 in T1DM patients. Comorbidities, higher FBG and HbA1c levels, not taking hydroxychloroquine, and vitamin D inadequacy elevate COVID-19 progression and severity in patients with T1DM.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Enrollment of participants in the study. TIDM: type 1 diabetes mellitus.
Figure 2
Figure 2
Correlations of vitamin D with (a) LDH, (b) CRP, (c) ESR, (d) ferritin, and (e) D-dimer in T1DM patients with and without COVID-19. Scatter plots show the levels of biomarkers at the levels of vitamin D. LDH: lactate dehydrogenase; CRP: C-reactive protein; ESR: erythrocyte sedimentation rate; T1DM: type 1 diabetes mellitus. ∗∗p < 0.01, ∗∗∗p > 0.001.
Figure 3
Figure 3
Area under the ROC curve for (a) D-dimer, (b) PT, and (c) APTT. AUC: area under the curve; ROC: receiver operating characteristic curve; PT: prothrombin time; APTT: activated partial thromboplastin time. The arrow refers to the best cut-off value.
See this image and copyright information in PMC

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