{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T04:52:05Z","timestamp":1777179125293,"version":"3.51.4"},"reference-count":52,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T00:00:00Z","timestamp":1669334400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Endocrino Diabet &amp; Metabol"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In sub\u2010Saharan Africa and particularly in Ghana, there is scarcity of published literature specifically on the impact of DM on outcomes in COVID\u201019 patients. Based on the difference in genetic makeup and demographic patterns in Africans compared to the Western world and with the rising burden of DM and other non\u2010communicable diseases in Ghana there is a need to define the impact DM has on persons with COVID\u201019. This would ensure adequate risk stratification and surveillance for such patients as well as appropriate scale up of therapeutic management if needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This single\u2010center study describes the clinical and laboratory profile and outcomes of COVID\u201019 in\u2010patients with type 2 diabetes mellitus (DM) in Ghana.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Retrospective analysis was undertaken of the medical records of adults with COVID\u201019 hospitalized at a facility in Ghana from March to October 2020. Clinical, laboratory and radiological data and outcomes were analysed. Comparisons between COVID\u201019 patients with DM and non\u2010diabetics were done with an independent t\u2010test or a Mann\u2013Whitney test when normality was not attained. Odds ratios (95% CI) were calculated using univariate logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 175 COVID\u201019 patients, 64 (36.6%) had DM. Overall mean age was 55.9\u2009\u00b1\u200918.3\u2009years; DM patients were older compared to non\u2010diabetics (61.1\u2009\u00b1\u200912.8 vs. 53.0\u2009\u00b1\u200920.2\u2009years, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.049). Compared to non\u2010diabetics, diabetics were more likely to have higher blood glucose at presentation, have hypertension, be on angiotensin 2 receptor blockers [OR, 95% CI 3.3 (1.6\u20136.7)] and angiotensin converting enzyme inhibitors [OR, 95% CI 3.1 (1.3\u20137.4)]; and be HIV negative (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). Although the values were normal, diabetics had a higher platelet count but decreased lymphocytes, aspartate transaminase and alkaline phosphatase compared to non\u2010diabetics (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). There was no difference in clinical symptoms, severity or mortality between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The clinical profile of patients studied are similar to prior studies. However the outcome of this study showed that DM was not associated with worse clinical severity and in\u2010hospital mortality. This could have been due to majority of DM patients in this study having relatively good blood glucose control on admission. Secondly, DM alone may not be a risk factor for mortality. Rather its concurrent existence with multiple co\u2010morbidities (especially cardiovascular co\u2010morbidities which may predispose to pro\u2010inflammatory and pro\u2010thrombotic states) may be driving the rise in severity and mortality risks reported in other studies. Furthermore, this study was conducted among an African population and Africa has been shown to be generally less severely hit by the COVID\u201019 pandemic compared to other regions outside the continent. This has been postulated to be due, among other factors, to inherent protective mechanisms in Africans due to early and repeated exposure to parasitic and other organisms resulting in a robust innate immunity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study suggested that DM was not associated with more severe clinical symptoms or worse outcomes among hospitalized COVID\u201019 patients. Despite this, it is important that DM patients adhere to their therapy, observe the COVID\u201019 containment protocols and are prioritized in the administration of the COVID\u201019 vaccines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study highlights<\/jats:title><jats:p>In this retrospective, single\u2010centre study on the clinical and laboratory profile and outcome of hospitalized DM patients with COVID\u201019, patients with DM did not have a more severe clinical profile or worse outcomes. They were, however, significantly older, more likely to have higher admission blood glucose, have hypertension, be on angiotensin 2 receptor blockers and angiotensin converting enzyme inhibitors; and be HIV negative compared to the cohort without DM. DM patients should be a priority group for the COVID\u201019 vaccines.<\/jats:p><\/jats:sec>","DOI":"10.1002\/edm2.391","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T13:58:40Z","timestamp":1669384720000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Clinical and laboratory profile and outcomes of hospitalized COVID\u201019 patients with type 2 diabetes mellitus in Ghana \u2013 A\u00a0single\u2010center study"],"prefix":"10.1002","volume":"6","author":[{"given":"Yasmine Oladele","family":"Hardy","sequence":"first","affiliation":[{"name":"Directorate of Medicine, Komfo Anokye Teaching Hospital  Kumasi Ghana"},{"name":"School of Medical Sciences Kwame Nkrumah University of Science and Technology  Kumasi Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Libhaber","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine and Health Sciences Research Office, Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9558-5632","authenticated-orcid":false,"given":"Emmanuel","family":"Ofori","sequence":"additional","affiliation":[{"name":"Directorate of Medicine, Komfo Anokye Teaching Hospital  Kumasi Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Divine\u00a0Aseye\u00a0Yao","family":"Amenuke","sequence":"additional","affiliation":[{"name":"Directorate of Medicine, Komfo Anokye Teaching Hospital  Kumasi Ghana"},{"name":"School of Medical Sciences Kwame Nkrumah University of Science and Technology  Kumasi Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel Amoabeng","family":"Kontoh","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Health Sciences Kwame Nkrumah University of Science and Technology  Kumasi Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James Amoah","family":"Dankwah","sequence":"additional","affiliation":[{"name":"Directorate of Medicine, Komfo Anokye Teaching Hospital  Kumasi Ghana"},{"name":"School of Medical Sciences Kwame Nkrumah University of Science and Technology  Kumasi Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Larsen\u2010Reindorf","sequence":"additional","affiliation":[{"name":"Ghana Health Service, Ashanti Regional Health Directorate  Kumasi Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caleb","family":"Otu\u2010Ansah","sequence":"additional","affiliation":[{"name":"Directorate of Psychiatry, Komfo Anokye Teaching Hospital  Kumasi Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kojo","family":"Hutton\u2010Mensah","sequence":"additional","affiliation":[{"name":"Directorate of Medicine, Komfo Anokye Teaching Hospital  Kumasi Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ebenezer","family":"Dadson","sequence":"additional","affiliation":[{"name":"Directorate of Radiology, Komfo Anokye Teaching Hospital  Kumasi Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheila","family":"Adamu","sequence":"additional","affiliation":[{"name":"Directorate of Medicine, Komfo Anokye Teaching Hospital  Kumasi Ghana"},{"name":"School of Medical Sciences Kwame Nkrumah University of Science and Technology  Kumasi Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kofi","family":"Akyerekoh","sequence":"additional","affiliation":[{"name":"Directorate of Medicine, Komfo Anokye Teaching Hospital  Kumasi Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fred Stephen","family":"Sarfo","sequence":"additional","affiliation":[{"name":"Directorate of Medicine, Komfo Anokye Teaching Hospital  Kumasi Ghana"},{"name":"School of Medical Sciences Kwame Nkrumah University of Science and Technology  Kumasi Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"Nkum","sequence":"additional","affiliation":[{"name":"Directorate of Medicine, Komfo Anokye Teaching Hospital  Kumasi Ghana"},{"name":"School of Medical Sciences Kwame Nkrumah University of Science and Technology  Kumasi Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,11,25]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"BHIVA DAIG EACS GESIDA.Polish Scientific AIDS Society and Portuguese Association for the clinical study of AIDS (APECS). Accessed February 4 2021.https:\/\/www.bhiva.org\/joint\u2010statement\u2010on\u2010risk\u2010of\u2010COVID\u201019\u2010for\u2010PLWH\u2010and\u2010SARS\u2010CoV\u20102\u2010vaccine\u2010advice"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.2648"},{"key":"e_1_2_9_4_1","unstructured":"COVID Live.Coronavirus Statistics \u2013 Worldometercited October 23 2022.https:\/\/www.worldometers.info\/coronavirus\/"},{"key":"e_1_2_9_5_1","unstructured":"BHIVA DAIG EACS GESIDA Polish Scientific AIDS Society and Portuguese Association for the clinical study of AIDS (APECS).GmbH B EACS Statement 15 January 2021 EACSociety.2021[cited Febuary 4 2021]. https:\/www.eacsociety.org\/home\/bhiva\u2010daig\u2010eacs\u2010gesida\u2010polish\u2010scientific\u2010aids\u2010society\u2010and\u2010portuguese\u2010association\u2010for\u2010the\u2010clinical\u2010study\u2010of\u2010aids\u2010apecs\u2010statement\u2010on\u2010risk\u2010of\u2010covid\u201019\u2010for\u2010people\u2010living\u2010with\u2010hiv\u2010plwh\u2010and\u2010sars\u2010cov\u20102\u2010vaccine\u2010advice\u2010for\u2010adults\u2010living\u2010with\u2010hiv.html"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/JLB.5VMR0118-021RR"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2012.02.026"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-1170"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2020-001343"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/1932296820924469"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2020.108263"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2020.37.32.25192"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.20-1240"},{"issue":"2","key":"e_1_2_9_14_1","first-page":"58","article-title":"Clinical characteristics and outcomes of COVID\u201019 infection in nine pregnant women: a report from a sub\u2010Saharan African country, Senegal","volume":"35","author":"Diouf AA","year":"2020","journal-title":"Pan Afr Med J"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.4314\/gmj.v54i4s.7"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.3719"},{"issue":"4","key":"e_1_2_9_17_1","first-page":"4","article-title":"Presentation and Outcome of COVID\u201019 in HIV Patients with High Viral Loads and Opportunistic Infections: A Case Series","volume":"54","author":"Hardy YO","year":"2020","journal-title":"Ghana Med J"},{"issue":"46","key":"e_1_2_9_18_1","first-page":"1","article-title":"Ghana's burden of chronic non\u2010communicable diseases: future directions in research, practice and policy","volume":"1","author":"De\u2010Graft Aikins A","year":"2012","journal-title":"Ghana Med J"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0194677"},{"key":"e_1_2_9_20_1","unstructured":"MOH.COVID\u201019\u2010STG\u2010JUNE\u20102020\u20101.pdf. [cited January 4 2021].https:\/\/www.moh.gov.gh\/wp\u2010content\/uploads\/2016\/02\/COVID\u201019\u2010STG\u2010JUNE\u20102020\u20101.pdf"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-S002"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-020-01382-7"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2020.571037\/full"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0248281"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s42399-020-00341-w"},{"key":"e_1_2_9_26_1","first-page":"1","article-title":"COVID\u201019 and diabetes mellitus: from pathophysiology to clinical management","volume":"13","author":"Lim S","year":"2020","journal-title":"Nat Rev Endocrinol"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2020.05.033"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8227(01)00374-6"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0241824"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2020.108227"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.5603\/DK.2020.0002"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-S013"},{"key":"e_1_2_9_33_1","first-page":"212249","article-title":"Therapeutic approaches to slowing the progression of diabetic nephropathy \u2013 is less best?","volume":"2013","author":"Vivian E","year":"2013","journal-title":"Drugs Context"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2020-317393"},{"issue":"6","key":"e_1_2_9_35_1","first-page":"450","article-title":"Clinical characteristics and outcomes of 112 cardiovascular disease patients infected by 2019\u2010nCoV","volume":"48","author":"Peng YD","year":"2020","journal-title":"Zhonghua Xin Xue Guan Bing Za Zhi"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0244129"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.5935\/1676\u20102444.20200049"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.04.006"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2020.10.001"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s42399-020-00380-3"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25829"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-2377"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/1652403"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(20)30405-8"},{"key":"e_1_2_9_45_1","unstructured":"World Health Organisation.New WHO estimates: Up to 190 000 people could die of COVID\u201019 in Africa if not controlled. WHO Regional Office for Africa. [cited Febuary 11 2021].https:\/\/www.afro.who.int\/news\/new\u2010who\u2010estimates\u2010190\u2010000\u2010people\u2010could\u2010die\u2010covid\u201019\u2010africa\u2010if\u2010not\u2010controlled"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30212-6"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.virol.2021.10.003"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2008410117"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(20)30238-2"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-020-01184-4"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2020.04.004"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.12270"},{"issue":"4","key":"e_1_2_9_53_1","first-page":"7","article-title":"Sociodemographic and clinical characteristics of the first cohort of COVID\u201019 re\u2010 coveries at two national treatment centres in Accra, Ghana","volume":"54","author":"Owoo C","year":"2020","journal-title":"Ghana Med J"}],"container-title":["Endocrinology, Diabetes &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/edm2.391","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/edm2.391","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/edm2.391","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T17:17:58Z","timestamp":1692551878000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/edm2.391"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,25]]},"references-count":52,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1002\/edm2.391"],"URL":"https:\/\/doi.org\/10.1002\/edm2.391","archive":["Portico"],"relation":{},"ISSN":["2398-9238","2398-9238"],"issn-type":[{"value":"2398-9238","type":"print"},{"value":"2398-9238","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,25]]},"assertion":[{"value":"2022-09-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e391"}}