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

Biomed Res Int. 2021 Nov 23:2021:1676914. doi: 10.1155/2021/1676914. eCollection 2021.

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.

MeSH terms

  • Adult
  • Biomarkers / blood*
  • Blood Cell Count
  • Blood Glucose / metabolism
  • Blood Sedimentation
  • C-Reactive Protein / metabolism
  • COVID-19 / blood
  • COVID-19 / epidemiology*
  • COVID-19 Drug Treatment*
  • Comorbidity
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Disease Progression
  • Female
  • Glycated Hemoglobin / metabolism
  • Humans
  • Hydroxychloroquine / therapeutic use*
  • Incidence
  • Male
  • Retrospective Studies
  • SARS-CoV-2
  • Saudi Arabia / epidemiology
  • Severity of Illness Index
  • Vitamin D / therapeutic use*

Substances

  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human
  • Vitamin D
  • Hydroxychloroquine
  • C-Reactive Protein