Diabetes mellitus and Covid-19: the double trouble

Objectives: To evaluate the variations in inflammatory responses among COVID-19 patients with and without diabetes mellitus (DM) and to determine whether comorbid DM is associated with more severe outcomes during COVID-19 infection. Methods: This cross-sectional, single-center study was conducted at Combined Military Hospital Malir, Karachi, Pakistan from July to December 2022. Ethical approval was obtained (ERC letter #78/2022/Trg/FCPS). Hospitalized COVID-19 patients with confirmed SARS-CoV-2 infection via PCR were included, while those with chronic inflammatory diseases, secondary diabetes, or pregnancy were excluded. Patients were classified into DM and non-DM (NDM) groups using American Diabetes Association criteria. COVID-19 severity was categorized based on national guidelines. Inflammatory biomarkers, including Interleukin-6 (IL-6), ferritin, and C-reactive protein (CRP), were measured within 48 hours of admission. Statistical analyses were performed using SPSS-23, with p≤0.05 considered significant. Results: The study analyzed 483 COVID-19-positive patients with a mean age of 45.43±13.19 years, predominantly male (69.3%). Among these, 130 (27.0%) had severe disease, and 135 (28.0%) had comorbid DM. Severe COVID-19 was more prevalent in DM patients (43.7%) compared to non-diabetics (20.4%, p<0.001). Serum levels of CRP (Q1–Q3: 6.10–31.57 mg/L), Ferritin (Q1–Q3: 182–352 ηg), and IL-6 (Q1–Q3: 5.98–39.78 ρg/ml), were significantly higher in COVID-19 patients with DM compared to non-diabetic patients (p <0.001). Conclusion: COVID-19 patients with comorbid DM exhibit heightened inflammatory responses and are at a greater risk of severe disease compared to non-diabetic patients. This highlights the importance of stringent monitoring and tailored management strategies for diabetic patients during COVID-19 infections.