Abstract
Data from 118 hospitalized patients admitted to the ICU of the TSMU First University Clinic were analyzed. Inclusion criteria were: need for respiratory support due to respiratory failure at the time of hospitalization - HFNC, CPAP (oxygen saturation on room air < 90% and respiratory rate > 30); a diagnosis of type 2 diabetes mellitus for >5 years; confirmed SARS-CoV-2 infection detected by polymerase chain reaction (PCR) identifying viral genetic material in a nasopharyngeal swab.
Patient sex, age, comorbidities, clinical and laboratory data were analyzed, as well as blood glucose levels at admission in relation to outcomes during the acute phase of the disease: clinical deterioration, transfer to the intensive care unit and need for invasive mechanical ventilation (IMV), subsequent recovery or lethal outcome at £7 days, £14 days, and £ 28 days.
In this patient group, the most significant clinical features of the viral phase of the disease were high and persistent fever, early development of respiratory failure, and neurological disorders, including severe headache, agitation, inappropriate behavior, and sleep inversion.
A high mortality rate was observed among patients with type 2 diabetes mellitus and severe COVID-19, even under ICU conditions. Increased mortality was associated with prolonged hospitalization and the development of severe, generalized bacterial infections. Hyperglycemia at the time of hospitalization markedly increased the risk of mortality. Among comorbidities, chronic obstructive pulmonary disease (COPD) also significantly increased the likelihood of an unfavorable outcome.
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