Critically ill patients with diabetes and Middle East respiratory syndrome: a multi-center observational study

Jesna Jose; Hasan M. Al-Dorzi; Awad Al-Omari; Yasser Mandourah; Fahad Al-Hameed; Musharaf Sadat; Eman Al Qasim; Basem Alraddadi; Abdulrahman Al Harthy; Ghaleb A. Al Mekhlafi; Abdullah Almotairi; Kasim Al Khatib; Ahmed Abdulmomen; Ismael Qushmaq; Anees A. Sindi; Ahmed Mady; Othman Solaiman; Rajaa Al-Raddadi; Khalid Maghrabi; Ahmed Ragab; Ayman Kharaba; Sarah Shalhoub; Abdulsalam M. Al-Aithan; Gajendra K. Vishwakarma; Atanu Bhattacharjee; Yaseen M. Arabi

doi:10.1186/s12879-021-05771-y

Critically ill patients with diabetes and Middle East respiratory syndrome: a multi-center observational study

Jesna Jose, Hasan M. Al-Dorzi, Awad Al-Omari, Yasser Mandourah, Fahad Al-Hameed, Musharaf Sadat, Eman Al Qasim, Basem Alraddadi, Abdulrahman Al Harthy, Ghaleb A. Al Mekhlafi, Abdullah Almotairi, Kasim Al Khatib, Ahmed Abdulmomen, Ismael Qushmaq, Anees A. Sindi, Ahmed Mady, Othman Solaiman, Rajaa Al-Raddadi, Khalid Maghrabi, Ahmed RagabAyman Kharaba, Sarah Shalhoub, Abdulsalam M. Al-Aithan, Gajendra K. Vishwakarma, Atanu Bhattacharjee, Yaseen M. Arabi (Lead / Corresponding author),

Population Health and Genomics

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Abstract

Background: Diabetes is a risk factor for infection with coronaviruses. This study describes the demographic, clinical data, and outcomes of critically ill patients with diabetes and Middle East Respiratory Syndrome (MERS).

Methods: This retrospective cohort study was conducted at 14 hospitals in Saudi Arabia (September 2012–January 2018). We compared the demographic characteristics, underlying medical conditions, presenting symptoms and
signs, management and clinical course, and outcomes of critically ill patients with MERS who had diabetes compared to those with no diabetes. Multivariable logistic regression analysis was performed to determine if
diabetes was an independent predictor of 90-day mortality.

Results: Of the 350 critically ill patients with MERS, 171 (48.9%) had diabetes. Patients with diabetes were more likely to be older, and have comorbid conditions, compared to patients with no diabetes. They were more likely to
present with respiratory failure requiring intubation, vasopressors, and corticosteroids. The median time to clearance of MERS-CoV RNA was similar (23 days (Q1, Q3: 17, 36) in patients with diabetes and 21.0 days (Q1, Q3: 10, 33) in patients with no diabetes). Mortality at 90 days was higher in patients with diabetes (78.9% versus 54.7%, p <0.0001). Multivariable regression analysis showed that diabetes was an independent risk factor for 90-day mortality
(odds ratio, 2.09; 95% confidence interval, 1.18–3.72).

Conclusions: Half of the critically ill patients with MERS have diabetes; which is associated with more severe disease. Diabetes is an independent predictor of mortality among critically patients with MERS.

Original language	English
Article number	84
Number of pages	9
Journal	BMC Infectious Diseases
Volume	21
DOIs	https://doi.org/10.1186/s12879-021-05771-y
Publication status	Published - 19 Jan 2021

Keywords

Acute respiratory distress syndrome
Coronavirus
Diabetes
Middle East respiratory syndrome

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1186/s12879-021-05771-yLicence: CC BY

Final published versionFinal published version, 670 KBLicence: CC BY

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Jose, J., Al-Dorzi, H. M., Al-Omari, A., Mandourah, Y., Al-Hameed, F., Sadat, M., Al Qasim, E., Alraddadi, B., Al Harthy, A., Al Mekhlafi, G. A., Almotairi, A., Al Khatib, K., Abdulmomen, A., Qushmaq, I., Sindi, A. A., Mady, A., Solaiman, O., Al-Raddadi, R., Maghrabi, K. (2021). Critically ill patients with diabetes and Middle East respiratory syndrome: a multi-center observational study. BMC Infectious Diseases, 21, Article 84. https://doi.org/10.1186/s12879-021-05771-y

@article{2821b4cfa5e54b0ea374768a86a763d9,

title = "Critically ill patients with diabetes and Middle East respiratory syndrome: a multi-center observational study",

abstract = "Background: Diabetes is a risk factor for infection with coronaviruses. This study describes the demographic, clinical data, and outcomes of critically ill patients with diabetes and Middle East Respiratory Syndrome (MERS).Methods: This retrospective cohort study was conducted at 14 hospitals in Saudi Arabia (September 2012–January 2018). We compared the demographic characteristics, underlying medical conditions, presenting symptoms andsigns, management and clinical course, and outcomes of critically ill patients with MERS who had diabetes compared to those with no diabetes. Multivariable logistic regression analysis was performed to determine ifdiabetes was an independent predictor of 90-day mortality.Results: Of the 350 critically ill patients with MERS, 171 (48.9%) had diabetes. Patients with diabetes were more likely to be older, and have comorbid conditions, compared to patients with no diabetes. They were more likely topresent with respiratory failure requiring intubation, vasopressors, and corticosteroids. The median time to clearance of MERS-CoV RNA was similar (23 days (Q1, Q3: 17, 36) in patients with diabetes and 21.0 days (Q1, Q3: 10, 33) in patients with no diabetes). Mortality at 90 days was higher in patients with diabetes (78.9% versus 54.7%, p <0.0001). Multivariable regression analysis showed that diabetes was an independent risk factor for 90-day mortality(odds ratio, 2.09; 95% confidence interval, 1.18–3.72).Conclusions: Half of the critically ill patients with MERS have diabetes; which is associated with more severe disease. Diabetes is an independent predictor of mortality among critically patients with MERS.",

keywords = "Acute respiratory distress syndrome, Coronavirus, Diabetes, Middle East respiratory syndrome",

author = "Jesna Jose and Al-Dorzi, {Hasan M.} and Awad Al-Omari and Yasser Mandourah and Fahad Al-Hameed and Musharaf Sadat and {Al Qasim}, Eman and Basem Alraddadi and {Al Harthy}, Abdulrahman and {Al Mekhlafi}, {Ghaleb A.} and Abdullah Almotairi and {Al Khatib}, Kasim and Ahmed Abdulmomen and Ismael Qushmaq and Sindi, {Anees A.} and Ahmed Mady and Othman Solaiman and Rajaa Al-Raddadi and Khalid Maghrabi and Ahmed Ragab and Ayman Kharaba and Sarah Shalhoub and Al-Aithan, {Abdulsalam M.} and Vishwakarma, {Gajendra K.} and Atanu Bhattacharjee and Arabi, {Yaseen M.}",

note = "Copyright: {\textcopyright} The Author(s) 2021.",

year = "2021",

month = jan,

day = "19",

doi = "10.1186/s12879-021-05771-y",

language = "English",

volume = "21",

journal = "BMC Infectious Diseases",

issn = "1471-2334",

publisher = "Springer Verlag",

}

Jose, J, Al-Dorzi, HM, Al-Omari, A, Mandourah, Y, Al-Hameed, F, Sadat, M, Al Qasim, E, Alraddadi, B, Al Harthy, A, Al Mekhlafi, GA, Almotairi, A, Al Khatib, K, Abdulmomen, A, Qushmaq, I, Sindi, AA, Mady, A, Solaiman, O, Al-Raddadi, R, Maghrabi, K, Ragab, A, Kharaba, A, Shalhoub, S, Al-Aithan, AM, Vishwakarma, GK, Bhattacharjee, A, Arabi, YM 2021, 'Critically ill patients with diabetes and Middle East respiratory syndrome: a multi-center observational study', BMC Infectious Diseases, vol. 21, 84. https://doi.org/10.1186/s12879-021-05771-y

TY - JOUR

T1 - Critically ill patients with diabetes and Middle East respiratory syndrome

T2 - a multi-center observational study

AU - Jose, Jesna

AU - Al-Dorzi, Hasan M.

AU - Al-Omari, Awad

AU - Mandourah, Yasser

AU - Al-Hameed, Fahad

AU - Sadat, Musharaf

AU - Al Qasim, Eman

AU - Alraddadi, Basem

AU - Al Harthy, Abdulrahman

AU - Al Mekhlafi, Ghaleb A.

AU - Almotairi, Abdullah

AU - Al Khatib, Kasim

AU - Abdulmomen, Ahmed

AU - Qushmaq, Ismael

AU - Sindi, Anees A.

AU - Mady, Ahmed

AU - Solaiman, Othman

AU - Al-Raddadi, Rajaa

AU - Maghrabi, Khalid

AU - Ragab, Ahmed

AU - Kharaba, Ayman

AU - Shalhoub, Sarah

AU - Al-Aithan, Abdulsalam M.

AU - Vishwakarma, Gajendra K.

AU - Bhattacharjee, Atanu

AU - Arabi, Yaseen M.

PY - 2021/1/19

Y1 - 2021/1/19

N2 - Background: Diabetes is a risk factor for infection with coronaviruses. This study describes the demographic, clinical data, and outcomes of critically ill patients with diabetes and Middle East Respiratory Syndrome (MERS).Methods: This retrospective cohort study was conducted at 14 hospitals in Saudi Arabia (September 2012–January 2018). We compared the demographic characteristics, underlying medical conditions, presenting symptoms andsigns, management and clinical course, and outcomes of critically ill patients with MERS who had diabetes compared to those with no diabetes. Multivariable logistic regression analysis was performed to determine ifdiabetes was an independent predictor of 90-day mortality.Results: Of the 350 critically ill patients with MERS, 171 (48.9%) had diabetes. Patients with diabetes were more likely to be older, and have comorbid conditions, compared to patients with no diabetes. They were more likely topresent with respiratory failure requiring intubation, vasopressors, and corticosteroids. The median time to clearance of MERS-CoV RNA was similar (23 days (Q1, Q3: 17, 36) in patients with diabetes and 21.0 days (Q1, Q3: 10, 33) in patients with no diabetes). Mortality at 90 days was higher in patients with diabetes (78.9% versus 54.7%, p <0.0001). Multivariable regression analysis showed that diabetes was an independent risk factor for 90-day mortality(odds ratio, 2.09; 95% confidence interval, 1.18–3.72).Conclusions: Half of the critically ill patients with MERS have diabetes; which is associated with more severe disease. Diabetes is an independent predictor of mortality among critically patients with MERS.

AB - Background: Diabetes is a risk factor for infection with coronaviruses. This study describes the demographic, clinical data, and outcomes of critically ill patients with diabetes and Middle East Respiratory Syndrome (MERS).Methods: This retrospective cohort study was conducted at 14 hospitals in Saudi Arabia (September 2012–January 2018). We compared the demographic characteristics, underlying medical conditions, presenting symptoms andsigns, management and clinical course, and outcomes of critically ill patients with MERS who had diabetes compared to those with no diabetes. Multivariable logistic regression analysis was performed to determine ifdiabetes was an independent predictor of 90-day mortality.Results: Of the 350 critically ill patients with MERS, 171 (48.9%) had diabetes. Patients with diabetes were more likely to be older, and have comorbid conditions, compared to patients with no diabetes. They were more likely topresent with respiratory failure requiring intubation, vasopressors, and corticosteroids. The median time to clearance of MERS-CoV RNA was similar (23 days (Q1, Q3: 17, 36) in patients with diabetes and 21.0 days (Q1, Q3: 10, 33) in patients with no diabetes). Mortality at 90 days was higher in patients with diabetes (78.9% versus 54.7%, p <0.0001). Multivariable regression analysis showed that diabetes was an independent risk factor for 90-day mortality(odds ratio, 2.09; 95% confidence interval, 1.18–3.72).Conclusions: Half of the critically ill patients with MERS have diabetes; which is associated with more severe disease. Diabetes is an independent predictor of mortality among critically patients with MERS.

KW - Acute respiratory distress syndrome

KW - Coronavirus

KW - Diabetes

KW - Middle East respiratory syndrome

UR - http://www.scopus.com/inward/record.url?eid=2-s2.0-85100170453&partnerID=MN8TOARS

U2 - 10.1186/s12879-021-05771-y

DO - 10.1186/s12879-021-05771-y

M3 - Article

SN - 1471-2334

VL - 21

JO - BMC Infectious Diseases

JF - BMC Infectious Diseases

M1 - 84

ER -

Critically ill patients with diabetes and Middle East respiratory syndrome: a multi-center observational study

Abstract

Keywords

UN SDGs

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