Clinical/biochemical characteristics and related outcomes in people with new-onset diabetes and COVID-19: experience from a single centre

Aims: It is known that there is a bidirectional relationship between diabetes mellitus (DM) and coronavirus disease (COVID-19). It has been described that those patients infected with SARS-CoV-2 could develop severe metabolic decompensation of pre-existing or new-onset DM, although diabetogenic effect of SARS-CoV-2 has still not been well consolidated. In fact, the coexistence of SARS-CoV-2 infection and new-onset DM is an infrequent situation. Methods: We describe the clinical and analytical characteristics of 19 patients admitted to a Spanish tertiary hospital - all 19 having COVID-19 infection and new-onset DM. Results: 12/19 patients (63.2%) were female; the mean age at diagnosis of DM was 54 (39-65) years. The most frequent ethnic group was Caucasian (n=9), followed by Latin-American (n=7); 7/19 (36.8%) previously met criteria for prediabetes due to altered basal glycaemia or HbA(1c). The mean BMI at diagnosis was 32.26kg/m(2) (27.62-35.18kg/m(2)). Eighteen of 19 patients (94.7%) showed bilateral bronchopneumonia. The mean blood glucose of the first blood was 17.5mmol/L (11.1-21.1mmol/L), and the mean HbA(1c) was 88mmol/mol (60-115mmol/mol). C-peptide was requested in eight patients and it was within normal range in 87.5% (n=7) and below the inferior threshold in one case. Autoantibodies were requested in 26.3% (five patients), being negative in 4/5 (80%) and positive in 1/5 (20%). Regarding the type of diabetes diagnosed, 18 were type 2 DM and only one case was diagnosed with type 1 DM. Seventeen had simple hyperglycaemia and two suffered a diabetic ketoacidosis. The mean HbA(1c) at 8.0 months (5.0-12.0 months) follow-up was 42mmol/mol (40-49mmol/mol). Conclusion: The majority of those described had type 2 DM that appears to have been unmasked by the COVID-19 infection, since they had high HbA(1c) and several risk factors for diabetes development, such as obesity and prediabetes. Most of them had their pancreatic reserve preserved, and this may suggest insulin resistance as the aetiology rather than direct beta-cell damage. A good evolution of diabetes after hospital discharge was observed in the patients followed up at our centre. Copyright (c) 2022 John Wiley & Sons.