Journal of Cardio-Thoracic Medicine

Journal of Cardio-Thoracic Medicine

Covid-19 Infection is Associated with Diabetes Mellitus in The MASHAD Cohort Study

Document Type : Original Article

Authors
Maryam Saberi-Karimian 1
Hamideh Safarian-Bana 2
Sara Saffar 2
Hamideh Ghazizadeh 2
Ehsan Mosa Farkhani 3
Maryam Mohammadi Bajgiran 4
Alireza Pakar 2
Habibollah Esmaily 5
Ensieh Akbarpour Bahre 5
Gordon A. Ferns 6
Mohsen Mouhebati 7
Majid Ghayour-Mobarhan 4
1 Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
2 International UNESCO Center for Health Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Deputy of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
4 International UNESCO center for Health Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
5 Department of Biostatistics & Epidemiology, School of Health, Management & Social Determinants of Health Research Center, Mashhad University of Medical sciences, Mashhad, Iran
6 Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex BN1 9PH, UK.
7 Cardiovascular Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
10.22038/jctm.2021.58101.1332
Abstract
Introduction: Previous studies have suggested that diabetes mellitus and obesity are associated with an increased risk of severe complications with COVID. We aimed to investigate whether individuals with obesity and diabetes mellitus are more likely to be infected with COVID19.
Methods: The information related to COVID-19 was extracted from the Sina Health system information of Mashhad Health Deputy among participants in Mashhad cohort study (n=9704 people). Information regarding the cardiac risk factors of the individuals was previously recorded during the recruitment phase of the Mashhad cohort study. The relationship between COVID infection and several CVD risk factors was investigated.
Results: The results showed that obesity (P= 0.001) and diabetes mellitus (DM), (P= 0.01) were positively related to COVID-19. Furthermore, DM augmented the risk of COVID-19 by 1.79 folds (P-value= 0.004; OR: 1.79; CI:1.21-2.67).
Conclusions: The incidence of COVID-19 until 2020.07.19 was 2.36% in Mashhad Study Cohort population. Moreover, DM has increased the risk of COVID-19 by 1.79 folds in the population. 
Keywords
COVID-19
Cardiovascular disease
Risk factor
  1. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The lancet. 2020.
  2. Clerkin KJ, Fried JA, Raikhelkar J, Sayer G, Griffin JM, Masoumi A, et al. COVID-19 and Cardiovascular Disease. Circulation. 2020;141(20):1648-55.
  3. Organization WH. Coronavirus disease (COVID-19), Situation Report–115, Data as received by WHO from national authorities by 10: 00 CEST, 14 May 2020.
  4. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9.
  5. Driggin E, Madhavan MV, Bikdeli B, Chuich T, Laracy J, Biondi-Zoccai G, et al. Cardiovascular considerations for patients, health care workers, and health systems during the COVID-19 pandemic. Journal of the American College of Cardiology. 2020;75(18):2352-71.
  6. Paramasivam A, Priyadharsini JV, Raghunandhakumar S, Elumalai P. A novel COVID-19 and its effects on cardiovascular disease. Hypertension Research. 2020:1-2.
  7. Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential effects of coronaviruses on the cardiovascular system: a review. JAMA cardiology. 2020.
  8. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The lancet. 2020;395(10223):507-13.
  9. Hui DS, Azhar EI, Madani TA, Ntoumi F, Kock R, Dar O, et al. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health—The latest 2019 novel coronavirus outbreak in Wuhan, China. International Journal of Infectious Diseases. 2020;91:264-6.
  10. Yang J, Feng Y, Yuan M, Yuan S, Fu H, Wu B, et al. Plasma glucose levels and diabetes are independent predictors for mortality and morbidity in patients with SARS. Diabetic medicine. 2006;23(6):623-8.
  11. Yu C, Wong RS, Wu E, Kong S, Wong J, Yip GW, et al. Cardiovascular complications of severe acute respiratory syndrome. Postgraduate medical journal. 2006;82(964):140-4.
  12. Badawi A, Ryoo SG. Prevalence of comorbidities in the Middle East respiratory syndrome coronavirus (MERS-CoV): a systematic review and meta-analysis. International Journal of Infectious Diseases. 2016;49:129-33.
  13. Guan W-j, Ni Z-y, Hu Y, Liang W-h, Ou C-q, He J-x, et al. Clinical characteristics of coronavirus disease 2019 in China. New England Journal of Medicine. 2020;382(18):1708-20.
  14. Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis. International Journal of Infectious Diseases. 2020.
  15. Nishiga M, Wang DW, Han Y, Lewis DB, Wu JC. COVID-19 and cardiovascular disease: from basic mechanisms to clinical perspectives. Nature Reviews Cardiology. 2020:1-16.
  16. Li B, Yang J, Zhao F, Zhi L, Wang X, Liu L, et al. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clinical Research in Cardiology. 2020;109(5):531-8.
  17. Hariyanto TI, Kurniawan A. Dyslipidemia is associated with severe coronavirus disease 2019 (COVID-19) infection. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020.
  18. Hedayatnia M, Asadi Z, Zare-Feyzabadi R, Yaghooti-Khorasani M, Ghazizadeh H, Ghaffarian-Zirak R, et al. Dyslipidemia and cardiovascular disease risk among the MASHAD study population. Lipids in Health and Disease. 2020;19(1):1-11.
  19. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395(10223):497-506.
  20. Guan W-j, Ni Z-y, Hu Y, Liang W-h, Ou C-q, He J-x, et al. Clinical characteristics of coronavirus disease 2019 in China. New England Journal of Medicine. 2020.
  21. Guan W-j, Liang W-h, Zhao Y, Liang H-r, Chen Z-s, Li Y-m, et al. Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide Analysis. European Respiratory Journal. 2020;55(5).
  22. Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. International Journal of Infectious Diseases. 2020;94:91-5.
  23. Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. Jama. 2020.
  24. Nikpouraghdam M, Farahani AJ, Alishiri G, Heydari S, Ebrahimnia M, Samadinia H, et al. Epidemiological characteristics of coronavirus disease 2019 (COVID-19) patients in IRAN: A single center study. Journal of Clinical Virology. 2020.
  25. Atkins JL, Masoli JA, Delgado J, Pilling LC, Kuo C-L, Kuchel GA, et al. Preexisting Comorbidities Predicting COVID-19 and Mortality in the UK Biobank Community Cohort. The Journals of Gerontology: Series A. 2020.
  26. Hussain A, Bhowmik B, do Vale Moreira NC. COVID-19 and diabetes: Knowledge in progress. Diabetes research and clinical practice. 2020:108142.
  27. Knapp S. Diabetes and infection: Is there a link?-A mini-review. Gerontology. 2013;59(2):99-104.
  28. Petrie JR, Guzik TJ, Touyz RM. Diabetes, hypertension, and cardiovascular disease: clinical insights and vascular mechanisms. Canadian Journal of Cardiology. 2018;34(5):575-84.
  29. Moutschen M, Scheen A, Lefebvre P. Impaired immune responses in diabetes mellitus: analysis of the factors and mechanisms involved. Relevance to the increased susceptibility of diabetic patients to specific infections. Diabete & metabolisme. 1992;18(3):187.
  30. Geerlings SE, Hoepelman AI. Immune dysfunction in patients with diabetes mellitus (DM). FEMS Immunology & Medical Microbiology. 1999;26(3-4):259-65.
  31. Ilyas R, Wallis R, Soilleux EJ, Townsend P, Zehnder D, Tan BK, et al. High glucose disrupts oligosaccharide recognition function via competitive inhibition: a potential mechanism for immune dysregulation in diabetes mellitus. Immunobiology. 2011;216(1-2):126-31.
  32. Kohio HP, Adamson AL. Glycolytic control of vacuolar-type ATPase activity: a mechanism to regulate influenza viral infection. Virology. 2013;444(1-2):301-9.
  33. Lange P, Groth S, Kastrup J, Mortensen J, Appleyard M, Nyboe J, et al. Diabetes mellitus, plasma glucose and lung function in a cross-sectional population study. European Respiratory Journal. 1989;2(1):14-9.
  34. Popov D, Simionescu M. Alterations of lung structure in experimental diabetes, and diabetes associated with hyperlipidaemia in hamsters. European Respiratory Journal. 1997;10(8):1850-8.
Journal of Cardio-Thoracic Medicine
Volume 10, Issue 1
Winter 2022
Pages 913-918