Sociodemographic factors, clinical characteristics, outcomes and short-term follow-up in COVID-19 patients with new onset hyperglycemia and pre-existing diabetes on admission in a tertiary-care hospital in Bangladesh

Background: COVID-19 has been linked to hyperglycemia and diabetes, with noteworthy variation in outcomes. This study aimed to compare the sociodemographic factors, clinical characteristics, and in-hospital and short-term post-discharge outcomes between COVID-19 patients with new onset hyperglycemia and pre-existing diabetes patients in tertiary care hospitals in Bangladesh.

Methods: A prospective observational study was conducted among adult COVID-19 patients with new onset hyperglycemia or pre-existing diabetes admitted to the COVID-19 unit of Dhaka Medical College Hospital between April 2021 and October 2021. Patients were conveniently selected from indoors. Bivariate analysis was used to compare sociodemographic and clinical characteristics at admission and short-term outcomes. The Cox proportional hazard model was used to examine factors associated with time to death in the hospital. All statistical analyses were performed using Stata Version 17.

Results: A total of 169 patients were included. Of these, 29 died in the hospital, and four left against medical advice. Out of the 136 survivors, 135 came for follow-up two weeks after discharge. At baseline, 30.18% of patients had new onset hyperglycemia, and 69.8% had pre-existing diabetes. The average age of patients was 56.38 ± 14.21 years, and 60.36% were male. A significantly higher proportion of COVID-19 patients with new onset hyperglycemia were smokers than those with pre-existing diabetes (p = 0.003). However, pre-existing diabetes was associated with higher lung involvement (p = 0.047) and comorbidities (p = 0.002). Age, income over 35,000 BDT (USD 335.5$), and a BMI over 25 kg/m2 emerged as significant predictors of prolonged hospital stay and mortality. Post-discharge follow-up indicated that new-onset hyperglycemia resolved in 8.89% of patients, whereas 19.26% continued to exhibit hyperglycemia, with smoking being a significant determinant of its persistence (p = 0.001).

Conclusion: In conclusion, our investigation illuminates the clinical trajectory of new-onset hyperglycemia in the context of COVID-19 and reinforces the necessity for diligent monitoring and management post-discharge. Therefore, close monitoring and follow-up of COVID-19 patients is recommended for the early detection and management of hyperglycemia and the prevention of diabetes development in the long run.