A survey carried out in Brazil showed that 4 out of 10 patients hospitalized with Covid who had diabetes died from the disease caused by the coronavirus in 2020.
According to the study, having diabetes mellitus, a disease that affects about 9% of the country’s adult population, was related to a prevalence of 2.5 out of 10 hospitalized for Covid in Brazil.
However, when considering the patients hospitalized by Covid who died in the studied period, which was the first year of the pandemic, the prevalence of diabetes rose to 40.8%, or 4 in 10 victims.
The study, conducted by researchers at the State University of Ceará, was published this Monday (30) in the journal Epidemiology and Health Services.
To assess the impact of diabetes on the mortality of hospitalized patients with Covid, the scientists analyzed data from Sivep-Gripe, from the Ministry of Health, which gathers reports of hospitalizations and deaths due to Srag (Severe Acute Respiratory Syndrome) from February to August. 2020 and compared the outcome between patients with and without the disease.
Patients who did not have the result of the RT-PCR test confirmed for the coronavirus and those who did not have information about the period of hospitalization or who were not hospitalized were excluded. In the end, the set had data on 397,600 people hospitalized with Covid.
Of the total number of hospitalized patients in the analyzed period, 32% (127,231) died. Among patients with diabetes, the mortality prevalence was 40.8% (41,766), although about 25% of the total number of patients (102,389) were diagnosed with the disease.
After adjusting the hospitalization data for other factors such as age, sex, and the presence of other comorbidities, the researchers saw a 15% higher risk of death in individuals with diabetes mellitus compared to non-diabetics, which is equivalent to saying that every 20 deaths , 3 are by patients with diabetes.
Thus, at least in the first year of the pandemic, the study found a higher prevalence of deaths from Covid in people with diabetes, even when other factors that may also contribute to mortality, such as age, are ruled out.
According to the nurse and researcher at Uece, Thiago Garces, the analysis of the data corroborated what several other studies had already seen about the greater impact of Covid on people with other chronic non-communicable diseases (NCDs), despite have a cutout for hospitalized patients only.
“When evaluating the data of hospitalized patients, who already have a condition above moderate with the disease, we are not evaluating the prevalence of general mortality (or worldwide, as we call it), so it was already expected that the risk would be higher”, he explains.
Some factors that may contribute to this, according to him, are the high inflammatory condition of hospitalized patients, who need anti-inflammatory drugs such as dexamethasone, which can further increase the blood glucose level, harming the condition of diabetic patients.
Another factor that may contribute to this is the viral load of the virus that infects these individuals and the damage caused to some gastrointestinal organs, such as the pancreas.
However, Garces reinforces that today, with vaccines, the risk is lower than in the first year of the pandemic. “Today I would say to a diabetic patient that even with what we found in the study, he has a reduced risk, because we already have vaccination, including booster doses for people over 60 years old”, he says.
It is important, however, that care for the most vulnerable population continues precisely to prevent infection, even in vaccinated people. “People with other NCDs already have limitations of the condition itself, so we don’t know what consequences a viral infection can have in these patients,” he says.
Several studies seek to understand the effects of long-term Covid and how it develops, especially which people are most likely to have symptoms of the disease even months after the initial infection. Having type 2 diabetes, according to a study carried out in the United States and released in January, is one of the factors that can lead to long-term Covid.
“What we’ve seen is that people with diabetes, hypertension, heart failure and other chronic diseases have had symptoms of Covid longer. important to maintain prevention”, he adds.