ODP633 Impact of Undiagnosed Diabetes on Cardiovascular Events and Clinical outcomes in Patients Hospitalized with COVID-19 Pneumonia

Abstract Type 2 diabetes has emerged as an important risk factor for poor prognosis in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Hyperglycemia can independently predispose the patients with SARS-CoV-2 to adverse outcomes, irrespective of the diagnosis of diabetes 1. Despite the accentuated risk, there is limited evidence about the complex interplay of undiagnosed diabetes and SARS-CoV-2 pneumonia on the clinical outcomes. We propose to investigate the cardiovascular events and clinical outcomes in patients with undiagnosed and type 2 diabetes hospitalized with SARS-CoV-2 pneumonia. Methods This retrospective study included patients hospitalized with SARS-CoV-2 pneumonia between March 7, 2020, through March 30, 2021. The diagnosis of SARS-CoV-2 pneumonia required a positive reverse transcriptase polymerase chain reaction (RT-PCR) for SARS-CoV-2, presence of new or worsening pulmonary infiltrates on computed tomography scan or chest X-ray, and at least one of the following: new or increased cough, a temperature of >37.8 °C or dyspnea. The diagnosis of undiagnosed diabetes was determined in patients with no previous history of diabetes and glycated hemoglobin (HbA1c) ≥ 6.5% (48 mmol/mol) or an admission serum glucose ≥ 200 mg/dL (≥ 11.1 mmol/mol). The outcomes included in-hospital cardiovascular events, intensive care unit (ICU) admissions and in-hospital mortality. Logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for association of undiagnosed diabetes and type 2 diabetes for individual outcomes. Results Among the 1,645 adults hospitalized with SARS-CoV-2 pneumonia, 107 (10.8%) patients were identified with undiagnosed diabetes and 634 (39%) had established diagnosis of type 2 diabetes. Patients with undiagnosed diabetes had increased odds of developing cardiovascular events (OR: 1.73, 95% CI 1. 07, 2.80), ICU admissions (OR: 1.61, 95% CI 1.10, 2.34), and mortality (OR: 1.77, 95% CI 1. 02, 3. 07), compared to patients type 2 diabetes and no diabetes. A prior history of type 2 diabetes was not significantly associated with primary study outcomes. Conclusions Patients with undiagnosed diabetes hospitalized with SARS-CoV-2 pneumonia have an increased risk of developing cardiovascular complications and overall poor clinical outcomes compared to patients with type 2 diabetes and no diabetes. Implementation of healthcare-wide strategies for screening and early intervention of prediabetes and diabetes are needed to improve the disease outcomes in the current pandemic and future public health threats. References Khunti, K., et al., COVID-19, Hyperglycemia, and New-Onset Diabetes. Diabetes Care, 2021. 44(12): p. 2645-2655. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.