Patients With Type 2 Diabetes and CKD Face Poor COVID Outcom
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The authors found 3,852 patients admitted with COVID infection, of whom 1,254 had T2D and 1,122 had GFR data. A little more than half had early-stage CKD, while 18.8% had stage 3b disease, 16.3% had stage 4, and 14.4% had stage 5. Among this group of hospitalized patients, 88% had pre-exiting hypertension upon admission. Pre-existing obesity (50%) and pulmonary disease (38%) were also both common comorbidities.

The authors reported that, overall, patients with stage 5 CKD (GFR <15 mL/min) had significantly higher odds of ICU admission, mechanical ventilation, mortality, and a length of stay of 1 week or longer. These patients with end-stage kidney disease had the longest hospital durations of all the CKD categories, averaging a 15-day stay. Those with stage 3b CKD (GFR 30-44 mL/min) and stage 4 CKD (GFR 15-29 mL/min) both averaged around a 10-day hospital stay. Patients with a normal GFR or early-stage 1/2/3a CKD (GFR 45 mL/min) averaged around an 8-day hospital stay for COVID.

In a single-center study of patients with T2D and CKD hospitalized with COVID-19 infection, having hyperglycemia upon admission was tied with more than a 10 times higher risk of severe COVID illness (OR 10.49, 95% CI 3.09-35.60). Also, patients with stage 5 CKD, or were on dialysis at the time of hospitalization, had over four times higher risk for a severe course of COVID illness (OR 4.67, 95% CI 2.25-9.71). Study data suggests that the combination of progressive CKD and T2D amplifies their individual impacts by magnitudes.