Research Article	Investigating the Effect of Type II Diabetes on COVID-19 Pneumonia Severity Using Computed Tomography: A Comparative Analysis Tip II Diyabetin COVID-19 Pnömoni Şiddeti Üzerindeki Etkisinin Bilgisayarlı Tomografi Kullanılarak Araştırılması: Karşılaştırmalı Bir Analiz *Ahmet Said ÇİL^1[ID] Abstract The aim of this study was to determine the factors affecting the severity of COVID-19 pneumonia in patients with type 2 diabetes using computed tomography severity scores. Computed tomography findings and pneumonia scores of 136 patients with type 2 diabetes and 136 patients without diabetes (n=272) with positive polymerase chain reaction test between January 2020 and January 2021 were compared using the hospital information system. The number of patients with moderate and severe pneumonia was significantly higher in the type 2 diabetes group (p<0.05). Pneumonia scores were significantly higher in type 2 diabetic patients older than 60 years (p<0.05). No significant correlation was found between pneumonia scores and hemoglobin A1c (p=0.865) and fasting blood glucose (p=0.78). No negative effect of hypertension on pneumonia score was observed in diabetic patients. Pneumonia scores of diabetic patients with renal insufficiency were higher than those of diabetic patients aged <60 years (P<0.05). In conclusion, the present study results revealed that the severity of COVID-19 pneumonia in patients with type 2 diabetes is higher than in healthy subjects. However, there was no significant positive correlation between pneumonia severity, hyperglycemia, and hemoglobin A1c levels in patients with type 2 diabetes. Keywords: COVID-19, Diabetes mellitus type 2, Computed tomography, Pneumonia. Özet Bu çalışmanın amacı tip 2 diyabetli hastalarda bilgisayarlı tomografi skorlarını kullanarak COVID-19 pnömonisinin şiddetini etkileyen faktörleri belirlemektir. Ocak 2020 ile Ocak 2021 tarihleri arasında polimeraz zincir reaksiyon testi pozitif olan 136 tip 2 diyabet hastası ile diyabeti olmayan 136 hastanın (n=272) bilgisayarlı tomografi bulguları ve pnömoni skorları hastane bilgi sistemi kullanılarak karşılaştırıldı. Tip 2 diyabet grubunda orta ve şiddetli pnömoni geçiren hasta sayısı anlamlı olarak daha fazlaydı (p<0.05). 60 yaş üstü tip 2 diyabetik hastalarda pnömoni skorları anlamlı olarak daha yüksek bulundu (p<0.05). Pnömoni skorları ile hemoglobin A1c (p=0.865) ve açlık kan şekeri (p=0.78) arasında ise anlamlı bir korelasyon bulunamadı. Diyabetik hastalarda hipertansiyonun pnömoni skoru üzerine olumsuz etkisi gözlenmedi. Böbrek yetmezliği olan diyabetik hastaların pnömoni skorları <60 yaş diyabetik hastalara göre daha yüksekti (P<0.05). Sonuç olarak çalışma verileri tip 2 diyabetli hastalarda COVID-19 pnömonisinin şiddetinin sağlıklı kişilere göre daha yüksek olduğunu göstermektedir. Tip 2 diyabetli hastalarda pnömoni şiddeti ile hiperglisemi ve hemoglobin A1c düzeyleri arasında ise anlamlı bir pozitif korelasyon saptanmamıştır. Anahtar kelimeler: COVID-19, Diyabetes mellitus tip 2, Bilgisayarlı tomografi, Pnömoni. Figure 1. Distribution of mild, moderate, and severe pneumonia in type 2 diabetes and control groups. Figure 1 png Şekil 1. Tip 2 diyabet ve kontrol gruplarında hafif, orta ve şiddetli pnömoninin dağılımı. Şekil 1 png Introduction Comorbidities accompanying COVID-19 infection lead to a more severe disease course, prolonged intensive care periods, and increased mortality [1,2]. One of the most common of these comorbidities is Type 2 Diabetes Mellitus (T2DM) [3]. It has been reported that COVID-19 mortality and disease severity are significantly higher in patients with T2DM than in those without diabetes [3]. There are different studies on the effects of hyperglycemia on the clinical outcomes of COVID-19 [4–7]. Patients with T2DM have additional comorbidities such as renal failure and heart diseases [2,3]. These diseases also affect the immune system negatively [2,3]. Aging is another factor that adversely affects the immune system [8]. Computed Tomography (CT) has been the most important imaging method showing the severity of pneumonia during the COVID-19 pandemic, and different scoring systems have been developed to determine the severity of pneumonia [9,10]. In this study, it was aimed to investigate the factors affecting the severity of pneumonia in patients with type 2 diabetes using CT. Material and Method Permission was obtained from the Faculty of Medicine Clinical Research Ethics Committee (Decision No:2022-21/177 date:22.11.2022) before the study. Patient consent form was not used because the study was retrospective. All procedures were carried out in accordance with the ethical rules and the principles of the Declaration of Helsinki. Study population and data collection This retrospective cross-sectional study was conducted in a university hospital. The study groups were selected from unvaccinated patients with pulmonary infiltration on CT of the thorax who were diagnosed with COVID-19 pneumonia by SARS-CoV-2 polymerase chain reaction (PCR) test between January 2020 and January 2021, when the vaccination program had not yet started. Demographic characteristics of the study groups; comorbidities; and clinical, laboratory, and radiological findings of the patients were retrospectively evaluated using the hospital automation system. After the group of patients with T2DM who met the inclusion criteria was formed, a control group was formed of patients with COVID-19 pneumonia without known comorbidities in the same number and age group. Image analysis Chest CT scans were performed on Toshiba Alexion 16-slice and General Electric (GE) Lightspeed 128-slice CT scanners using standard acquisition protocols. The chest CT images of all patients were evaluated by the same radiologist with more than 20 years of experience using the hospital registry system. To read more, see the pdf format of the article ...
DOI: 10.46683/jmvi.2024.84
Article in English
^1Department of Radiology, Ahi Evran University Faculty of Medicine, Kırşehir, Türkiye.
*Corresponding author Ahmet Said Çil; MD., Department of Radiology, Ahi Evran University Faculty of Medicine, Kırşehir, Türkiye. E-mail: asaidcil@hotmail.com
Received: 08.11.2023 Accepted: 20.12.2023 Published: 02.01.2024
Cite as: Çil AS. Investigating the Effect of Type II Diabetes on COVID-19 Pneumonia Severity Using Computed Tomography: A Comparative Analysis. J Mol Virol Immunol 2024; 5(1): 1-6.
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