LBSUN154 Baseline Albuminuria May Protect Against Severe Covid-19 In Type 2 Diabetes Patients

BACKGROUND: Diabetes is considered as one of the leading risk factors for severe COVID-19. We aimed to characterize the differences between type 2 diabetic patients after hospitalization in medical departments at our medical center due to COVID-19 or other diseases. Among the patients with COVID-19, we explored clinical parameters that were associated with severe disease. Method: This is a case-control study of diabetic patients after medical department hospitalization between 09/2020-05/2021. Patients with COVID-19 were compared to those without COVID-19. Patients were defined as COVID-19 negative if the SARS-CoV- 2 polymerase chain reaction and serology were negative and COVID-19 positive, according to a positive SARS-CoV- 2 polymerase chain reaction. Baseline albuminuria was defined as urine albumin to creatinine ratio ≥ 30 mg/gr before hospitalization. Patients that had COVID-19 were recruited after their discharge while other diabetic patients were recruited during hospitalization. Multivariable logistic regression was used to determine the risk factors for severe or critical COVID-19, as compared to mild or moderate disease. In the multivariable analysis: the severity of COVID-19 was the dependent variable, while the following variables were independent variables: eGFR, HbA1C and albuminuria before hospitalization, age and polymorphonuclear(PMN) /lymphocytes (NLR max) during hospitalization, and BMI and gender during recruitment. RESULTS: 65 diabetic patients after COVID-19 and 144 diabetic patients who were hospitalized in the Medical department due to other reasons were recruited. Patients after hospitalization due to other diagnoses (not COVID-19) were older than patients after COVID-19: (p=0. 005), had longer duration of diabetes (p=0. 03), lower eGFR (p=0. 03) and lower C-reactive protein (CRP) at admission (p<0. 001). In addition, baseline albuminuria was more common in patients without COVID-19 (54.9% versus 30.8%, p= 0. 002). In a multivariate logistic regression analysis that included only patients after COVID-19 infection, a higher body mass index (BMI) was significantly associated with severe COVID-19 pneumonia, OR 1.24 (95% CI 1. 01-1.53, P=0. 04). Similarly, a higher maximal ratio of NLR- Max was significantly associated with severe COVID-19 OR 1.2 (95% CI 1. 06-1.37, P=0. 005). Surprisingly, the presence of albuminuria before hospitalization was associated with a reduced risk for severe COVID-19 OR 0. 09 (95% CI 0. 014-0.62, P=0. 015). CONCLUSIONS: These findings suggest that the presence of albuminuria in diabetic patients, may serve as a protective factor for severe COVID-19 pneumonia. Further studies are needed to explore this association and the implication to treatment intervention. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.