Baseline moderate-range albuminuria is associated with protection against severe COVID-19 pneumonia
Diabetes mellitus is considered a leading contributor to severe coronavirus disease 2019 (COVID-19). To characterize differences between hospitalized diabetic patients with without COVID-19, and parameters associated with COVID-19 severity for prediction. This case-control study included 209 patient...
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| Published in: | World journal of diabetes Vol. 13; no. 12; pp. 1154 - 1167 |
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| Main Authors: | , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
Baishideng Publishing Group Inc
15-12-2022
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Diabetes mellitus is considered a leading contributor to severe coronavirus disease 2019 (COVID-19).
To characterize differences between hospitalized diabetic patients with
without COVID-19, and parameters associated with COVID-19 severity for prediction.
This case-control study included 209 patients with type 2 diabetic mellitus hospitalized at the Galilee Medical Center (Nahariya, Israel) and recruited between September 2020 and May 2021, 65 patients with COVID-19 infection in dedicated wards and 144 COVID-19-negative patients in internal medicine wards hospitalized due to other reasons. Clinical parameters - including age, type of antiglycemic medications, presence of retinopathy, smoking history, body mass index (BMI), glycosylated hemoglobin, maximum neutrophil:lymphocyte ratio (NLR
), C-reactive protein (CRP), estimated glomerular filtration rate (eGFR), and albumin (blood and urine) - were compared between the two primary patient groups, and then between COVID-19-negative patients hospitalized due to infectious
non-infectious disease. Finally, we explored which parameters were associated with severe COVID-19 pneumonia.
COVID-19-negative patients were older (63.9 ± 9.9
59.8 ± 9.2,
= 0.005), and had longer duration of diabetes (
= 0.031), lower eGFR (
= 0.033), higher albumin (
= 0.026), lower CRP (
< 0.001), greater smoking prevalence (
< 0.001), and more baseline albuminuria (54.9%
30.8%,
= 0.005) at admission; 70% of COVID-19 patients with albuminuria had moderate-range albuminuria (albumin:creatinine 30-300 mg/g). Most of the patients with albuminuria had chronic kidney disease stage II (CKD II). Oral antiglycemic therapies were not significantly different between the two groups. Multivariable logistic regression showed that higher BMI was significantly associated with severe COVID-19 (OR 1.24, 95%CI: 1.01-1.53,
= 0.04), as was higher NLR
(OR 1.2, 95%CI: 1.06-1.37,
= 0.005). Surprisingly, pre-hospitalization albuminuria, mostly moderate-range, was associated with reduced risk (OR 0.09, 95%CI: 0.01-0.62,
= 0.015). Moderate-range albuminuria was not associated with bacterial infections.
Moderate-range albuminuria in COVID-19-positive diabetic patients with CKD II is associated with less severe COVID-19. Further studies should explore this potential biomarker for risk of COVID-19-related deterioration and early interventions. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Author contributions: Bashkin A was the guarantor and designed the study, and was responsible for conceptualization, project administration, supervision, methodology, writing, review and editing; Shehadeh M and Shbita L were responsible for data curation and participated in formal analysis; Namoura K, Haiek R, Boulos Y, and Kuyantseva E participated in data curation; Yakir O was responsible for formal analysis; Kruzel-Davila E was responsible for methodology, formal analysis, writing, review and editing. Corresponding author: Amir Bashkin, MD, Director, Doctor, Researcher, Department of Diabetes, Endocrinology, and Metabolism, Galilee Medical Center, Route 89, Nahariya 2210001, Israel. amirb@gmc.gov.il |
| ISSN: | 1948-9358 1948-9358 |
| DOI: | 10.4239/wjd.v13.i12.1154 |