Outcome of COVID-19 Positive Patients with type 2 Diabetes and Polypharmacy: an Examination of a Tertiary Hospital Cohort

Mohammed Danjuma¹, Bhagya Sree², Unwam jumbo³, Lina Al Tarawneh⁴, Rowan Mesilhy⁴, Aly Roa⁴, Hend AlObaidi⁴, Amal H ElMasaad⁴, Gamal AlFitori³, Islam Elzouki³  Lina Naseralallah^2,5

Keywords: COVID-19, polypharmacy, Diabetes Mellitus, adverse drug reactions

DOI: 10.63475/yjm.v4i1.0051

DOI URL: https://doi.org/10.63475/yjm.v4i1.0051

Publish Date: 22-05-2025

Pages: 117 - 122

Views: 4

Downloads: 6

Author Affiliation:

1 Consultant, Department of Medicine, Weill Cornell College of medicine, Internal medicine residency training program, Qatar university college of Medicine, Doha Qatar, 
2 Pharmacist, clinical pharmacy division, Hamad Medical Corporation, Doha Qatar 
3 Consultant, Internal medicine residency training program, Department of Medicine, hamad medical corporation, Doha Qatar, 
4 Consultant, Department of Medicine, Qatar university college of medicine 
5 Pharmacist, School of pharmacy, university of Birmingham, Birmingham, united kingdom 

Abstract

Background: COVID-19-positive patients are at increased risk of adverse clinical outcomes, with type 2 diabetes cohorts at substantially higher risk compared to the general population. The additional role of diabetic and non-diabetic polypharmacy in these patients' clinical course has remained unexamined. In this study we have comprehensively examined the role of polypharmacy in the determination of mortality outcomes in patients with COVID-19 clinical syndrome. 

Methods: We retrospectively examined case notes and electronic records of N = 497 patients with type 2 diabetes and COVID-19 infection. We ascertained the number of medications each patient was taking and used this to categorize the study cohort into diabetic [n = 246] (5 or more diabetic medications), and non-diabetic polypharmacy [n = 251] (5 or more non-diabetic medications). The primary outcome was the need for intensive care admission between the two groups. 

Results: In patients with “non-diabetic polypharmacy” (>5 medications), advancing age, and higher HBA1c levels, were associated with increased risk of Intensive care admission (OR 1.06 [CI 1.03-1.07], P = <0001), (OR 1.01 [CI 1.01- 1.20], P 0.017), respectively. Patients taking 5 or more non-diabetic medications had an increased likelihood of admission into the intensive care unit compared to those on lower medication thresholds (OR = 1.7; CI = 1.1 to 1.3; p-value = <0.0006). 

Conclusion: In an inpatient cohort of type 2 diabetic patients with COVID-19, non-diabetic polypharmacy was associated with a multiplicative risk of intensive care admissions. This will necessitate the need for periodic medication reviews