Fig. 1Flow chart of the study. COVID-19, coronavirus disease 2019; KNUH, Kyungpook National University Hospital; DSMC, Dongsan Medical Center; KNUCH, Kyungpook National University Chilgok Hospital; DCMC, Daegu Catholic Medical Center; PCR, polymerase chain reaction; DM, diabetes mellitus; PS, propensity score.
Fig. 2Mortality due to coronavirus disease 2019 in all patients (A) and propensity score-matched patients (B). The data were analyzed using the Kaplan-Meier method, and hazard ratios were calculated using a Cox proportional hazards model. Data are expressed as hazard ratio (HR) (95% confidence intervals [CI]). DM, diabetes mellitus
Fig. 3Mortality of coronavirus disease 2019 patients in subgroups defined according to age and sex. Patients aged <70 years (A) and >70 years (B); and male (C) and female (D) patients. Data were analyzed using a Cox proportional hazards model. Data are expressed as hazard ratio (HR) (95% confidence intervals [CI]). The model was adjusted for age, sex, and the presence of underlying diseases.
Table 1Baseline characteristics of the full group of participants and of propensity score-matched patients with coronavirus disease 2019
![dmj-44-602-i001.jpg]()
Characteristic |
Unmatched patients |
1:1 PS-matched patients |
Non-DM (n=847) |
DM (n=235) |
P value |
Non-DM (n=235) |
DM (n=235) |
P value |
Age, yr |
56.5±18.0 |
68.3±11.9 |
<0.01 |
69.7±12.4 |
68.3±11.9 |
0.21 |
Male sex |
278 (32.8) |
106 (45.1) |
<0.01 |
95 (40.4) |
106 (45.1) |
0.31 |
BMI, kg/m2
|
23.5±3.6 |
24.2±3.2 |
0.03 |
24.0±3.24 |
24.2±3.16 |
0.62 |
SBP, mm Hg |
133.2±20.7 |
137.6±19.6 |
<0.01 |
139.6±23.9 |
137.6±19.6 |
0.31 |
DBP, mm Hg |
81.8±27.7 |
80.3±12.0 |
0.39 |
84.4±48.9 |
80.3±12.0 |
0.21 |
Body temperature, ℃ |
37.0±0.6 |
37.0±0.7 |
0.25 |
37.0±0.6 |
37.0±0.7 |
0.65 |
Co-morbidity |
|
|
|
|
|
|
Any co-morbidity |
321 (37.9) |
175 (74.5) |
<0.01 |
168 (71.5) |
175 (74.5) |
0.47 |
Hypertension |
227 (26.8) |
147 (62.6) |
<0.01 |
148 (63.0) |
147 (62.6) |
0.50 |
Heart disease |
47 (5.5) |
27 (11.5) |
<0.01 |
22 (9.4) |
27 (11.5) |
0.27 |
Cerebrovascular disease |
42 (5.0) |
24 (10.3) |
<0.01 |
27 (11.5) |
24 (10.3) |
0.38 |
Chronic kidney disease |
14 (1.7) |
18 (7.7) |
<0.01 |
12 (5.1) |
18 (7.7) |
0.17 |
Chronic lung disease |
56 (6.6) |
16 (6.8) |
0.51 |
18 (7.7) |
16 (6.8) |
0.43 |
Cancer |
43 (5.1) |
17 (7.2) |
0.13 |
16 (6.8) |
17 (7.2) |
0.50 |
Symptoms and pneumonia |
|
|
|
|
|
|
Fever |
356 (42.2) |
110 (46.8) |
0.12 |
102 (43.8) |
110 (46.8) |
0.29 |
Dyspnea |
194 (23.0) |
74 (31.5) |
<0.01 |
58 (24.9) |
74 (31.5) |
0.07 |
Cough |
430 (50.9) |
100 (42.6) |
0.01 |
107 (45.9) |
100 (42.6) |
0.26 |
Sputum |
332 (39.3) |
74 (31.5) |
0.02 |
83 (35.6) |
74 (31.5) |
0.20 |
Rhinorrhea |
136 (16.1) |
20 (8.5) |
<0.01 |
33 (14.2) |
20 (8.5) |
0.04 |
Sore throat |
172 (20.4) |
31 (13.2) |
<0.01 |
43 (18.5) |
31 (13.2) |
0.08 |
Myalgia |
266 (31.5) |
60 (25.5) |
0.04 |
65 (27.9) |
60 (25.5) |
0.32 |
Headache |
245 (29.0) |
41 (17.4) |
<0.01 |
49 (21.0) |
41 (17.4) |
0.19 |
Diarrhea |
168 (19.9) |
29 (12.3) |
<0.01 |
39 (16.7) |
29 (12.3) |
0.11 |
Pneumonia |
582 (68.7) |
206 (87.7) |
<0.01 |
194 (82.6) |
206 (87.7) |
0.08 |
Medication |
|
|
|
|
|
|
Insulin |
0 |
19 (8.1) |
|
0 |
19 (8.1) |
<0.01 |
Sulfonylurea |
0 |
60 (25.5) |
|
0 |
60 (25.5) |
<0.01 |
Metformin |
0 |
113 (48.1) |
|
0 |
113 (48.1) |
<0.01 |
α-Glucosidase inhibitor |
0 |
2 (0.1) |
0.03 |
0 |
2 (0.1) |
0.03 |
Thiazolidinedione |
0 |
7 (3.0) |
<0.01 |
0 |
7 (3.0) |
<0.01 |
DPP-4 inhibitor |
0 |
85 (36.2) |
<0.01 |
0 |
85 (36.2) |
<0.01 |
SGLT-2 inhibitor |
0 |
8 (3.4) |
<0.01 |
0 |
8 (3.4) |
<0.01 |
RAS inhibitor |
105 (12.4) |
70 (29.8) |
<0.01 |
49 (20.9) |
70 (29.8) |
0.02 |
Calcium channel blocker |
116 (13.7) |
61 (26.0) |
<0.01 |
70 (29.8) |
61 (26.0) |
0.05 |
β-Blocker |
38 (4.5) |
30 (12.8) |
<0.01 |
23 (9.8) |
30 (12.8) |
0.32 |
Diuretic |
35 (4.1) |
40 (17.0) |
<0.01 |
19 (8.1) |
40 (17.0) |
<0.01 |
Laboratory findings on admission |
|
|
|
|
|
|
HbA1c, % |
5.79±0.70 |
7.70±1.79 |
<0.01 |
5.72±0.44 |
7.70±1.79 |
<0.01 |
Glucose, mg/dL |
109.9±30.6 |
186.7±101.1 |
<0.01 |
118.6±34.4 |
186.7±101.1 |
<0.01 |
WBCs, 103/μL |
5.50±2.45 |
6.86±3.62 |
<0.01 |
5.99±3.06 |
6.86±3.62 |
<0.01 |
Neutrophils, % |
60.4±14.6 |
69.0±15.1 |
<0.01 |
64.5±15.0 |
69.0±15.1 |
<0.01 |
Lymphocytes, % |
28.8±12.5 |
21.5±12.1 |
<0.01 |
24.9±12.3 |
21.5±12.1 |
<0.01 |
Hb, g/dL |
12.7±1.8 |
12.2±1.7 |
<0.01 |
12.7±4.0 |
12.2±1.7 |
0.11 |
Hct, % |
38.1±4.6 |
36.4±4.9 |
<0.01 |
37.0±5.1 |
36.4±4.9 |
0.15 |
PLTs, 103/μL |
226.2±83.3 |
234.0±104.3 |
0.23 |
223.9±84.3 |
234.0±104.3 |
0.25 |
CRP, mg/dL |
7.2±21.2 |
10.6±18.8 |
0.03 |
9.0±22.6 |
10.6±18.8 |
0.38 |
Albumin, g/dL |
3.93±0.49 |
3.64±0.56 |
<0.01 |
3.75±0.52 |
3.64±0.56 |
0.02 |
BUN, mg/dL |
15.1±9.8 |
21.0±17.6 |
<0.01 |
19.1±12.6 |
21.0±17.6 |
0.18 |
Cr, mg/dL |
0.91±1.16 |
1.27±1.70 |
<0.01 |
1.12±1.45 |
1.27±1.70 |
0.28 |
eGFR, mL/min/1.73 m2
|
98.8±36.0 |
79.7±35.1 |
<0.01 |
85.7±34.9 |
79.7±35.1 |
0.06 |
AST, IU/L |
44.4±216.8 |
40.8±42.6 |
0.80 |
51.9±311.9 |
40.8±42.6 |
0.59 |
ALT, IU/L |
33.2±107.0 |
30.4±33.0 |
0.69 |
33.7±145.6 |
30.4±33.0 |
0.74 |
LDH, IU/L |
458.8±260.8 |
552.6±432.1 |
<0.01 |
471.2±197.2 |
552.6±432.1 |
0.01 |
Procalcitonin, ng/mL |
0.29±2.19 |
0.58±3.01 |
0.19 |
0.56±3.70 |
0.58±3.01 |
0.95 |
Table 2In-hospital management and outcomes of patients with coronavirus disease 2019
![dmj-44-602-i002.jpg]()
Variable |
Unmatched patients |
1:1 PS-matched patients |
Non-DM |
DM |
P value |
Non-DM |
DM |
P value |
Treatment |
|
|
|
|
|
|
ICU |
73 (8.6) |
57 (24.3) |
<0.01 |
34 (14.5) |
57 (24.3) |
<0.01 |
High flow O2
|
52 (6.1) |
35 (14.9) |
<0.01 |
23 (9.8) |
35 (14.9) |
0.06 |
Ventilator |
38 (4.5) |
37 (15.7) |
<0.01 |
18 (7.7) |
37 (15.7) |
<0.01 |
CRRT |
8 (0.9) |
15 (6.4) |
<0.01 |
3 (1.3) |
15 (6.4) |
<0.01 |
ECMO |
5 (0.6) |
10 (4.3) |
<0.01 |
3 (1.3) |
10 (4.3) |
0.04 |
Duration |
|
|
|
|
|
|
Confirmation-releasea, day |
29.4±13.6 |
33.2±14.3 |
<0.01 |
31.9±13.4 |
33.2±14.3 |
0.39 |
Hospital lengtha, day |
24.6±13.3 |
29.3±15.1 |
<0.01 |
27.5±13.9 |
29.3±15.1 |
0.22 |
Outcome |
|
|
|
|
|
|
Release |
759 (89.6) |
182 (77.4) |
<0.01 |
207 (88.1) |
182 (77.4) |
<0.01 |
Severe disease |
94 (11.1) |
65 (27.7) |
<0.01 |
45 (19.1) |
65 (27.7) |
0.02 |
Death |
41 (4.8) |
44 (18.7) |
<0.01 |
18 (7.7) |
44 (18.7) |
<0.01 |
Table 3Multivariate model for the prediction of severe disease or death in coronavirus disease 2019 patients
![dmj-44-602-i003.jpg]()
Variable |
Non-DM patients |
DM patients |
Severe disease |
Death |
Severe disease |
Death |
Glucose, mg/dL |
1.01 (1.00–1.02) |
1.02 (1.00–1.04) |
1.00 (1.00–1.01) |
1.00 (0.99–1.00) |
WBCs, 103/μL |
1.01 (0.86–1.18) |
1.02 (0.78–1.34) |
1.12 (1.00–1.28) |
1.22 (1.06–1.41)a
|
Hb, g/dL |
1.13 (0.93–1.36) |
0.97 (0.55–1.74) |
1.14 (0.82–1.59) |
1.55 (1.07–2.26)b
|
PLT, 103/μL |
1.00 (0.99–1.01) |
0.99 (0.97–1.00) |
0.99 (0.99–1.00)b
|
0.99 (0.99–1.00)b
|
CRP, mg/dL |
1.03 (1.01–1.05)a
|
1.03 (0.99–1.07) |
0.99 (0.96–1.01) |
0.99 (0.96–1.02) |
Albumin, g/dL |
0.15 (0.04–0.55)a
|
0.53 (0.04–7.76) |
0.38 (0.14–1.02) |
0.19 (0.06–0.56)a
|
eGFR, mL/min/1.73 m2
|
1.00 (0.99–1.02) |
1.00 (0.98–1.03) |
0.99 (0.97–1.00) |
0.99 (0.98–1.01) |
AST, IU/L |
1.09 (1.04–1.14)a
|
1.10 (1.02–1.19)b
|
1.05 (1.02–1.08)a
|
1.03 (1.00–1.06)b
|
ALT, IU/L |
0.93 (0.88–0.98)a
|
0.93 (0.85–1.01) |
0.96 (0.92–0.99)a
|
0.96 (0.92–1.01) |
LDH, IU/L |
1.00 (1.00–1.01) |
1.00 (0.99–1.00) |
1.00 (1.00–1.01)b
|
1.00 (1.00–1.00) |