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Giovanna Rodriguez, Fausto Cabesaz, Jefferson Li, Johnathan Kirupakaran, Eunice Kim, Michael Caputo, Abidemi Idowu, Paulomi Dave, Deane Kitson, Nilson Tapia, Michelle Korson, Lyam Ciccone, Pierce Maslach, Dennies Nunez, Michael Okaikoi, Bianca Rodriguez, Dhiviyan Valentin, Alice Yau, Beishi Zheng, Thida Aye, Mabel Jimenez, Pramma Elayaperumal, Arslan Afzal, Orpah Daruwala, Belinda Williams, Taiga Inoue, Haris Asif, Gurbaj Singh, Alaa Kubaar, Sandra Iwuala, Eric Verassamy, Jose Escudero Martinez, Felix Filias, Nejat Zeyneloglu, Gul Bahtiyar, Clinical Characteristics and Outcomes Among COVID 19 Hospitalized Patients in a Community Hospital in New York City, Journal of the Endocrine Society, Volume 5, Issue Supplement_1, April-May 2021, Pages A336–A337, https://doi.org/10.1210/jendso/bvab048.686
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Abstract
Background: COVID-19 has disproportionally affected communities of color in the US. These communities exhibit higher prevalence of chronic preventable disease including type 2 diabetes mellitus (DM2) and obesity. DM2 and obesity have been linked to higher morbidity and mortality in the setting of COVID-19 infection (1).
Methods: We query data collected from 521 patients with laboratory-confirmed Covid-19 infection admitted to an inner-city community hospital in Brooklyn, New York between March 20 2020 and May 15 2020. Demographics, pre-infection medical comorbidities, laboratory data at admission and clinical outcomes including in-hospital mortality were analyzed.
Results: Patients were 61 years on average (+/-17.2), 42.8% were female, 53.9% were Hispanic and 33% were African-American. Most common comorbidities included: hypertension (62%), chronic kidney disease (20.8%), diabetes (45 %). Mean BMI was 29.9 (+/- 8.2). Among patients with no prior diagnosis of diabetes mean A1c was 5.8% (+/-1.2) and 8.7 (+/-2.5) amongst those with a previous diagnosis of diabetes. Patients hospitalized with moderate to severe COVID-19 infection and a previous diagnosis of DM2 had significantly higher prevalence of CKD and HTN. Amongst those with T2DM, 19.1% presented with DKA. After adjustment for age, gender, race, BMI and creatinine obese patients, compared with normal-weight patients had significantly higher mortality rate (BMI > 30 kg/m2 [OR: 2.29, CI: 95%, P-value: <0.002]) however this association was not observed for DM2 ([OR: 1.25, CI: 95%, P-value: <0.002]).
Conclusion: Our cohort represents a particular population affected by the first wave of Covid-19 infection in an urban inner-city community in NYC. The population studied had a larger proportion of African-American, Hispanic and younger patients compared to national averages; these differences are related to the demographics of the communities served by our hospital. Obesity is a negative prognostic factor in the course of Covid-19 infection in comparison to normal-weight patients. Obesity is a proinflammatory condition, associated with high levels of prothrombotic factors including angiotensin-II, also elevated in COVID-19. Understanding that link may yield valuable knowledge on the role obesity plays in numerous disease states beyond COVID-19. References:(1). Sabin ML, et al. Lancet. 2020;395(10232): 1243–44.(2). Hussain A, et al. Obes Res Clin Pract. 2020; 14(4): 295–300.
