# Dyslipidemia Associated With Type 2 Diabetes Mellitus as a Strong Predictor of ICU Admission in COVID-19 Patients: A Retrospective Comparative Study

## TL;DR

This study shows that having both dyslipidemia and type 2 diabetes strongly increases the risk of ICU admission for COVID-19 patients.

## Contribution

The study identifies dyslipidemia as a strong independent predictor of ICU admission in COVID-19 patients, even when combined with type 2 diabetes.

## Key findings

- Dyslipidemia and T2DM together are strongly associated with ICU admission (adjusted OR = 120.82).
- Dyslipidemia increases the risk of tachypnea, shortness of breath, and ICU admission independently.
- Abnormal cholesterol levels and fibrinogen are significantly linked to dyslipidemia in ICU patients.

## Abstract

Background: The global COVID-19 pandemic has raised questions about the complex interplay between chronic non-communicable diseases and the clinical trajectory of the disease. Among these, dyslipidemia and type 2 diabetes mellitus (T2DM) have emerged as significant contributors to adverse COVID-19 outcomes and intensive care unit (ICU) admissions. This retrospective comparative study was conducted at Prince Mohammed bin Abdulaziz Hospital in Riyadh, Kingdom of Saudi Arabia (KSA), and assessed the impact of dyslipidemia and T2DM on COVID-19 severity and ICU admission.

Methodology: A retrospective comparative study analyzed the data of 239 COVID-19 patients admitted to Prince Mohammed bin Abdulaziz Hospital in Riyadh between March and July 2020. The study assessed COVID-19 severity among patients with dyslipidemia and T2DM and the need for ICU admission. Data analysis employed odds ratios, Fisher's exact tests, and binary logistic regression using SPSS version 25 (IBM, SPSS, Chicago, IL, USA).

Results: The findings revealed a very strong association between dyslipidemia and T2DM coexistence (adjusted OR (aOR) = 120.82, P = 0.001). Dyslipidemia significantly increased the risk of tachypnea (aOR = 58.263, P = 0.003), shortness of breath (SoB) (aOR = 10.729 (1.251-92.016), P = 0.003), and the likelihood of ICU admission, independently, as well as in the presence of T2DM (aOR = 8.136, P = 0.026). The results showed a significant association with abnormal high-density lipoprotein (HDL) cholesterol, triglycerides, and total cholesterol (P < 0.05). Fever is notably linked to dyslipidemia (P = 0.048). Among inflammatory markers, fibrinogen showed a very strong association with dyslipidemia in the presence of T2DM, in the context of the ICU setting (1,235 (10.021-152,261.746), P = 0.004). Similarly, chest X-ray (CXR) findings also showed significant association with dyslipidemia (P = 0.039).

Conclusion: This study highlights the substantial impact of dyslipidemia, independently, as well as in the presence of T2DM, on ICU admission among COVID-19 patients in Riyadh, KSA. The findings emphasize the need for tailored care, early intervention, and optimized management of comorbid conditions. Proactive risk assessment in individuals with T2DM and dyslipidemia can reduce the probability of severe illness and ICU admission in COVID-19 patients.