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Abstract
Background: Patients with diabetes mellitus (DM) and cardiovascular disorders who suffer from COVID-19 may have an increased risk of death.
Objective: This study aims to analyze the time of death and influencing factors in patients with DM and cardiovascular disorders with COVID-19.
Methods: We used a retrospective observational cohort study using medical records of COVID-19 patients treated at Dr Soeradji and Penembahan Senopati hospitals from March 2020 to June 2022. There were 2,959 participants: patients without comorbidities, with DM, and with cardiovascular problems. We extracted sociodemographic and clinical data on patient characteristics using medical records. Data analysis used Kaplan-Meier and Cox regression analysis to estimate survival probability and investigate predictors of death with a 5% significance level.
Results: The median survival time was highest in the group without comorbidities (70.00) and lowest in the DM+others group (21.75). Years of treatment, age, presence of comorbidities, and type of hospital were related to the survival rate of COVID-19 patients (p<0.05). Diabetes mellitus and cardiovascular system disorders are significantly associated with survival of COVID-19 patients (p<0.001). There were significant differences between patients without cardiovascular disorders and patients with cardiovascular disorders (Non-Hypertension, Hypertension, and Hypertension + Others) adjusted by year, gender, age, and hospital type (p<0.001). There were significant differences between patients without DM and patients with DM (DM only, DM+Hypertension, and DM+Others) adjusted by year, gender, age, and hospital type(p<0.001).
Conclusion: Years of treatment, age, gender, comorbid DM, and cardiovascular problems are associated with the survival rate of COVID-19 patients. Older age, DM patients who have comorbidities other than hypertension, and patients with cardiovascular issues other than hypertension show a greater risk of death than other groups.
Key words: COVID-19, Diabetes Mellitus, Hypertension, Cardiovascular Diseases, Survival Rate.
References
Ahmad, O. B., Boschi-Pinto, C., Lopez, A. D., Murray, C. J., Lozano, R., & Inoue, M. (2001). Age standardization of rates: a new WHO standard. Geneva: World Health Organization, 9(10), 1-14. https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/gpe_discussion_paper_series_paper31_2001_age_standardization_rates.pdf
Albadawy, R. M., Jadoon, B. A., Mogahed, M. M., Ibrahim, M. E., Essawy, T. S., Amin, A. M., Abd-Elraouf, M. S., & Elawady, M. A. (2021). The impact of comorbidities on the outcomes of Egyptian COVID-19 patients: a follow-up study. Journal of Environmental and Public Health, 2021, 1-7. https://doi.org/https://doi.org/10.1155/2021/6662476
Asch, D. A., Sheils, N. E., Islam, M. N., Chen, Y., Werner, R. M., Buresh, J., & Doshi, J. A. (2021). Variation in US hospital mortality rates for patients admitted with COVID-19 during the first 6 months of the pandemic. JAMA internal medicine, 181(4), 471-478. https://doi.org/https://doi.org/10.1001/jamainternmed.2020.8193
Azhar, Z., Widyastuti, C. T., Khotimah, K., Rajin, M., Fatmawati, D. A., & Mawarti, H. (2021). Relationship of Commorbid Disease to Mortality Events in COVID-19 Patients. International Journal of Social Science, 1(2), 135-142. https://doi.org/https://doi.org/10.53625/ijss.v1i2.5046
Badkoubeh, R. S., Almassi, N., Farahani, M. M., Movassaghi, N., Khosravi, A., Mirdamadi, A., Kamali, M., Manshouri, S., Tabrizi, M. T., & Farrashi, M. (2020). The Iranian Society of Echocardiography (ISE) statement on performing echocardiography during the COVID-19 pandemic. Cardiol, 45, 100620.
Bae, S., Kim, S. R., Kim, M. N., Shim, W. J., & Park, S. M. (2021). Impact of cardiovascular disease and risk factors on fatal outcomes in patients with COVID-19 according to age: a systematic review and meta-analysis. Heart, 107(5), 373-380. https://doi.org/10.1136/heartjnl-2020-317901
Bello-Chavolla, O. Y., Bahena-López, J. P., Antonio-Villa, N. E., Vargas-Vázquez, A., González-Díaz, A., Márquez-Salinas, A., Fermín-Martínez, C. A., Naveja, J. J., & Aguilar-Salinas, C. A. (2020). Predicting mortality due to SARS-CoV-2: a mechanistic score relating obesity and diabetes to COVID-19 outcomes in Mexico. The Journal of Clinical Endocrinology & Metabolism, 105(8), 2752-2761. https://doi.org/https://doi.org/10.1210/clinem/dgaa346
Bepouka, B., Odio, O., Mangala, D., Mayasi, N., Mandina, M., Longokolo, M., Makulo, J. R., Mbula, M., Kayembe, J. M., & Situakibanza, H. (2022). Diabetes Mellitus is Associated With Higher COVID-19 Mortality Rates in Sub-Saharan Africa: A Systematic Review and Meta-analysis. Cureus, 14(7). https://doi.org/https://doi.org/10.7759/cureus.26877
Bhatt, A. S., Jering, K. S., Vaduganathan, M., Claggett, B. L., Cunningham, J. W., Rosenthal, N., Signorovitch, J., Thune, J. J., Vardeny, O., & Solomon, S. D. (2021). Clinical outcomes in patients with heart failure hospitalized with COVID-19. Heart Failure, 9(1), 65-73. https://doi.org/https://doi.org/10.1016/j.jchf.2020.11.003
Bobdey, S., Chawla, N., Behera, V., Ray, S., Ilankumaran, M., Koshy, G., & Kaushik, S. (2021). An analysis of mortality and survival of COVID 19 patients admitted to a tertiary care hospital in Maharashtra, India. medical journal armed forces india, 77, S353-S358.
Bobdey, S., Chawla, N., Behera, V., Ray, S., Ilankumaran, M., Koshy, G., & Kaushik, S. K. (2021). An analysis of mortality and survival of COVID 19 patients admitted to a tertiary care hospital in Maharashtra, India. Med J Armed Forces India, 77(Suppl 2), S353-s358. https://doi.org/10.1016/j.mjafi.2021.02.004
Bustos-Vázquez, E., Padilla-González, E., Reyes-Gómez, D., Carmona-Ramos, M. C., Monroy-Vargas, J. A., Benítez-Herrera, A. E., & Meléndez-Mier, G. (2021). Survival of COVID-19 with Multimorbidity Patients. Healthcare (Basel), 9(11). https://doi.org/10.3390/healthcare9111423
Byeon, K. H., Kim, D. W., Kim, J., Choi, B. Y., Choi, B., & Cho, K. D. (2021). Factors affecting the survival of early COVID-19 patients in South Korea: An observational study based on the Korean National Health Insurance big data. International Journal of Infectious Diseases, 105, 588-594. https://doi.org/https://doi.org/10.1016/j.ijid.2021.02.101
Chang, D., Chang, X., He, Y., & Tan, K. J. K. (2022). The determinants of COVID-19 morbidity and mortality across countries. Scientific Reports, 12(1), 5888. https://doi.org/10.1038/s41598-022-09783-9
Choi, Y. J., Park, J.-Y., Lee, H. S., Suh, J., Song, J. Y., Byun, M.-K., Cho, J. H., Kim, H. J., & Park, H. J. (2021). Variable effects of underlying diseases on the prognosis of patients with COVID-19. PloS one, 16(7), e0254258. https://doi.org/https://doi.org/10.1371/journal.pone.0254258
Dalia, T., Lahan, S., Ranka, S., Acharya, P., Gautam, A., Goyal, A., Mastoris, I., Sauer, A., & Shah, Z. (2021). Impact of congestive heart failure and role of cardiac biomarkers in COVID-19 patients: A systematic review and meta-analysis. Indian heart journal, 73(1), 91-98. https://doi.org/ https://doi.org/10.1016/j.ihj.2020.12.002
de Almeida-Pititto, B., Dualib, P. M., Zajdenverg, L., Dantas, J. R., de Souza, F. D., Rodacki, M., & Bertoluci, M. C. (2020). Severity and mortality of COVID 19 in patients with diabetes, hypertension and cardiovascular disease: a meta-analysis. Diabetol Metab Syndr, 12, 75. https://doi.org/10.1186/s13098-020-00586-4
Di Fusco, M., Shea, K. M., Lin, J., Nguyen, J. L., Angulo, F. J., Benigno, M., Malhotra, D., Emir, B., Sung, A. H., & Hammond, J. L. (2021). Health outcomes and economic burden of hospitalized COVID-19 patients in the United States. Journal of Medical Economics, 24(1), 308-317. https://doi.org/https://doi.org/10.1080/13696998.2021.1886109
Farhud, D. D., & Mojahed, N. (2022). SARS-COV-2 Notable Mutations and Variants: A Review Article. Iran J Public Health, 51(7), 1494-1501. https://doi.org/10.18502/ijph.v51i7.10083
Garbin, J. R. T., Leite, F. M. C., Lopes-Júnior, L. C., Dell'Antonio, C., Dell'Antonio, L. S., & Santos, A. (2022). Analysis of Survival of Patients Hospitalized with COVID-19 in Espírito Santo, Brazil. Int J Environ Res Public Health, 19(14). https://doi.org/10.3390/ijerph19148709
Gupta, S., Kaushik, A., & Gupta, J. (2020). Management and outcomes of patients hospitalized with severe COVID-19 at a tertiary care center in midwestern United States. Monaldi Archives for Chest Disease, 90(4). https://doi.org/https://doi.org/10.4081/monaldi.2020.1592
Hayek, S. S., Brenner, S. K., Azam, T. U., Shadid, H. R., Anderson, E., Berlin, H., Pan, M., Meloche, C., Feroz, R., & O’Hayer, P. (2020). In-hospital cardiac arrest in critically ill patients with covid-19: multicenter cohort study. bmj, 371. https://doi.org/https://doi.org/10.1136/bmj.m3513
Hirata, N., & Yamakage, M. (2021). Cardiovascular considerations for anesthesiologists during the COVID-19 pandemic. Journal of anesthesia, 35, 361-365. https://doi.org/https://doi.org/10.1007/s00540-020-02852-1
Huang, A. A., & Huang, S. Y. (2023). Diabetes is associated with increased risk of death in COVID‐19 hospitalizations in Mexico 2020: A retrospective cohort study. Health Science Reports, 6(7), e1416. https://doi.org/https://doi.org/10.1002/hsr2.1416
Imam, Z., Odish, F., Gill, I., O’Connor, D., Armstrong, J., Vanood, A., Ibironke, O., Hanna, A., Ranski, A., & Halalau, A. (2020). Older age and comorbidity are independent mortality predictors in a large cohort of 1305 COVID‐19 patients in Michigan, United States. Journal of internal medicine, 288(4), 469-476. https://doi.org/https://doi.org/10.1111/joim.13119
Kandil, H., Ibrahim, A. E., Afifi, N., & Arafa, A. (2021). Diabetes and risk of COVID-19 mortality: A systematic review and meta-analysis. Infectious Diseases in Clinical Practice (Baltimore, Md.), 29(3), e195. https://doi.org/https://doi.org/10.1097/IPC.0000000000000992
Kumar, A., Arora, A., Sharma, P., Anikhindi, S. A., Bansal, N., Singla, V., Khare, S., & Srivastava, A. (2020). Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14(4), 535-545. https://doi.org/https://doi.org/10.1016/j.dsx.2020.04.044
Lakhani, A., Laturkar, N., Dhok, A., & Mitra, K. (2022). Prognostic utility of cardiovascular indices in COVID-19 infection: A single-center prospective study in India. Journal of Family Medicine and Primary Care, 11(10), 6297. https://doi.org/https://doi.org/10.4103/jfmpc.jfmpc_501_22
Li, Z., Wang, X., Wu, Y., & Owzar, K. (2018). Sample size calculation for studies with grouped survival data. Stat Med, 37(27), 3904-3917. https://doi.org/10.1002/sim.7847
Lim, S., Bae, J. H., Kwon, H.-S., & Nauck, M. A. (2021). COVID-19 and diabetes mellitus: from pathophysiology to clinical management. Nature Reviews Endocrinology, 17(1), 11-30. https://doi.org/https://doi.org/10.1038/s41574-020-00435-4
Lv, G., Yuan, J., Xiong, X., & Li, M. (2021). Mortality rate and characteristics of deaths following COVID-19 vaccination. Frontiers in Medicine, 8, 670370. https://doi.org/https://doi.org/10.3389/fmed.2021.670370
Mok, J., Malpartida, J. C., O'Dell, K., Davis, J., Gao, C., & Manyam, H. (2021). Vascular comorbidities worsen prognosis of patients with heart failure hospitalised with COVID-19. Open heart, 8(1). https://doi.org/https://doi.org/10.1136/openhrt-2021-001668
Na, Y. S., Kim, J. H., Baek, M. S., Kim, W.-Y., Baek, A.-R., young Lee, B., Seong, G. M., & Lee, S.-I. (2022). In-hospital mortality prediction using frailty scale and severity score in elderly patients with severe COVID-19. Acute and Critical Care, 37(3), 303-311. https://doi.org/https://doi.org/10.4266/acc.2022.00017
Najjar, M., Albuaini, S., Fadel, M., Aljbawi, A., AlAwad, Y., & Mohsen, F. (2023). Impact of comorbidities on hospitalised Syrian patients with COVID-19: a retrospective study. BMJ open, 13(3), e068849. https://doi.org/https://doi.org/10.1136/bmjopen-2022-068849
Nasrullah, A., Gangu, K., Cannon, H. R., Khan, U. A., Shumway, N. B., Bobba, A., Sagheer, S., Chourasia, P., Shuja, H., & Avula, S. R. (2023). COVID-19 and Heart Failure with Preserved and Reduced Ejection Fraction Clinical Outcomes among Hospitalized Patients in the United States. Viruses, 15(3), 600. https://doi.org/https://doi.org/10.3390/v15030600
Niedziela, J. T., Jaroszewicz, J., Wita, K., Cieśla, D., & Gąsior, M. (2022). High in-hospital and post-discharge mortality in patients with a pre-existing diagnosis of heart failure hospitalized due to COVID-19. Kardiologia Polska (Polish Heart Journal), 80(1), 90-92. https://doi.org/https://doi.org/10.33963/KP.a2021.0163
Piskač Živković, N., Lucijanić, M., Bušić, N., Jurin, I., Atić, A., Andrilović, A., Penović, T., Domić, I., Gnjidić, J., & Demaria, M. (2022). The associations of age, sex, and comorbidities with survival of hospitalized patients with coronavirus disease 2019: data from 4014 patients from a tertiary-center registry. Croatian Medical Journal, 63(1), 36-43. https://doi.org/https://doi.org/10.3325/cmj.2022.63.36
Rossman, H., Meir, T., Somer, J., Shilo, S., Gutman, R., Ben Arie, A., Segal, E., Shalit, U., & Gorfine, M. (2021). Hospital load and increased COVID-19 related mortality in Israel. Nature communications, 12(1), 1904. https://doi.org/https://doi.org/10.1038/s41467-021-22214-z
Seong, G. M., Baek, A.-R., Baek, M. S., Kim, W.-Y., Kim, J. H., Lee, B. Y., Na, Y. S., & Lee, S.-I. (2021). Comparison of clinical characteristics and outcomes of younger and elderly patients with severe COVID-19 in Korea: a retrospective multicenter study. Journal of Personalized Medicine, 11(12), 1258. https://doi.org/https://doi.org/10.3390/jpm11121258
Sharif, N., Ahmed, S. N., Opu, R. R., Tani, M. R., Dewan, D., Daullah, M. U., Shanto, R. I., Parvez, A. K., Talukder, A. A., & Dey, S. K. (2021). Prevalence and impact of diabetes and cardiovascular disease on clinical outcome among patients with COVID-19 in Bangladesh. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 15(3), 1009-1016. https://doi.org/https://doi.org/10.1016/j.dsx.2021.05.005
Sousa, G. J. B., Garces, T. S., Cestari, V. R. F., Florêncio, R. S., Moreira, T. M. M., & Pereira, M. L. D. (2020). Mortality and survival of COVID-19. Epidemiol Infect, 148, e123. https://doi.org/10.1017/s0950268820001405
Souza, S. M. d., Quintão, A. P. d. C., Soares, M. C. B., Mendes, I. R., Freitas, B. A. C. d., Siman, A. G., & Toledo, L. V. (2022). Survival of patients with diabetes mellitus hospitalized for acute respiratory syndrome due to COVID-19. Revista do Instituto de Medicina Tropical de São Paulo, 64. https://doi.org/https://doi.org/10.1590/S1678-9946202264074
Ssentongo, P., Ssentongo, A. E., Heilbrunn, E. S., Ba, D. M., & Chinchilli, V. M. (2020). Association of cardiovascular disease and 10 other pre-existing comorbidities with COVID-19 mortality: A systematic review and meta-analysis. PloS one, 15(8), e0238215. https://doi.org/https://doi.org/10.1371/journal.pone.0238215
Surianta, A., & Patunru, A. A. (2024). The political economy of COVID‐19 vaccination in Indonesia. Asia & the Pacific Policy Studies, 11(1), e381.
Tanaka, C., Tagami, T., Nakayama, F., Kudo, S., Takehara, A., Fukuda, R., Kaneko, J., Ishiki, Y., Sato, S., & Shibata, A. (2021). Association between mortality and age among mechanically ventilated COVID-19 patients: a Japanese nationwide COVID-19 database study. Annals of Intensive Care, 11(1), 171. https://doi.org/https://doi.org/10.1186/s13613-021-00959-6
Woodall, M. N., Masonou, T., Case, K. M., & Smith, C. M. (2021). Human models for COVID‐19 research. The Journal of Physiology, 599(18), 4255-4267. https://doi.org/https://doi.org/10.1113/JP281499
World Health Organization, W. (2024). WHO COVID-19 dashboard. Retrieved January 31 from https://data.who.int/dashboards/covid19/cases?n=c
Yan, Y., Yang, Y., Wang, F., Ren, H., Zhang, S., Shi, X., Yu, X., & Dong, K. (2020). Clinical characteristics and outcomes of patients with severe covid-19 with diabetes. BMJ open diabetes research & care, 8(1). https://doi.org/https://doi.org/10.1136/bmjdrc-2020-001343
Yanez, N. D., Weiss, N. S., Romand, J.-A., & Treggiari, M. M. (2020). COVID-19 mortality risk for older men and women. BMC public health, 20(1), 1-7. https://doi.org/https://doi.org/10.1186/s12889-020-09826-8
Yoshino, H., & Takechi, H. (2021). Influences of COVID‐19 in a dementia outpatient clinic: experience from the Fujita‐Health University Hospital in Aichi, Japan. Psychogeriatrics, 21(3), 438. https://doi.org/https://doi.org/10.1111/psyg.12684
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