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Role of secondary sepsis in COVID-19 mortality: Observations on patients with preexisting diabetes mellitus and newly diagnosed hyperglycemia.
Nair, Aiswarya M; Gopalan, Sowmya; Rajendran, Vaasanthi; Varadaraj, Priyadarshini; Marappa, Lakshmi; Pandurangan, Viswanathan; Madhavan, Sudha; Mani, Rajkumar; Bhaskar, Emmanuel.
Afiliación
  • Nair AM; Department of Medicine, Sri Ramachandra Medical College and Research Institute, Porur. docaishnair@gmail.com.
  • Gopalan S; Department of Medicine, Sri Ramachandra Medical College and Research Institute, Porur. sowmya_js@yahoo.com.
  • Rajendran V; Department of Medicine, Sri Ramachandra Medical College and Research Institute, Porur. vaasanthi_r@yahoo.co.in.
  • Varadaraj P; Department of Medicine, Sri Ramachandra Medical College and Research Institute, Porur. priyavaradaraj@gmail.com.
  • Marappa L; Department of Medicine, Sri Ramachandra Medical College and Research Institute, Porur. lakshmimchandramohan@gmail.com.
  • Pandurangan V; Department of Medicine, Sri Ramachandra Medical College and Research Institute, Porur. viswa.smc@gmail.com.
  • Madhavan S; Department of Medicine, Sri Ramachandra Medical College and Research Institute, Porur. smsudhamadhavan@gmail.com.
  • Mani R; Department of Medicine, Sri Ramachandra Medical College and Research Institute, Porur. drrajkumar2000@yahoo.com.
  • Bhaskar E; Department of Medicine, Sri Ramachandra Medical College and Research Institute, Porur. drebhaskar@gmail.com.
Monaldi Arch Chest Dis ; 92(4)2022 Apr 12.
Article en En | MEDLINE | ID: mdl-35416000
Diabetics who develop severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) are more likely to have severe disease, higher odds of intensive care requirement and mortality. Fifteen percent of patients have new onset hyperglycemia. We studied the comparative outcomes between prior DM, newly detected hyperglycemia and assessed role of secondary sepsis on mortality. RWe performed a r etrospective study of confirmed SARS-CoV-2 patients at a tertiary care hospital in Chennai, India. Patients were divided as 2 groups (Group 1: With preexisting diabetes mellitus, Group 2: With newly diagnosed hyperglycemia due to newly detected diabetes mellitus or non-diabetic hyperglycemia. Clinical and laboratory data was analysed. Two hundred and thirty eight patients had prior-diabetes mellitus (Group 1) and 40 had newly diagnosed hyperglycemia (Group 2). Thirty four of group 1 and 7 of group 2 patients required intensive care. Mean capillary blood glucose (MCBG) during hospital stay was 207 mg/dl (Group 1) and 192 mg/dl (Group 2). Twentysix patients (9.3%) had secondary sepsis of which sixteen died. Logistic regression identified secondary sepsis(p<0.0001), elevated D-dimer >6 fold (p= 0.0001), elderly p=0.0045), male (p=0.0006), NLR >5 (p=0.01),serum creatinine ≥2 mg/dl (p=0.0004), FiO2 requirement >0.6 in first 48 hours (p=0.001) as mortality predictors.Our study observed a 14.38 % prevalence of newly diagnosed DM or non-diabetic hyperglycemia. Secondary sepsis and >6 fold elevation in D-dimer were strong predictors of mortality. Steroid use possibly contributed to secondary sepsis. Early identification and aggressive management of secondary sepsis are necessary for diabetics.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sepsis / Diabetes Mellitus / COVID-19 / Hiperglucemia Tipo de estudio: Diagnostic_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans / Male País/Región como asunto: Asia Idioma: En Revista: Monaldi Arch Chest Dis Año: 2022 Tipo del documento: Article Pais de publicación: Italia
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sepsis / Diabetes Mellitus / COVID-19 / Hiperglucemia Tipo de estudio: Diagnostic_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans / Male País/Región como asunto: Asia Idioma: En Revista: Monaldi Arch Chest Dis Año: 2022 Tipo del documento: Article Pais de publicación: Italia