COVID-19 in High-Risk Diabetes Patients

High-risk PLWD satisfying the inclusion criteria were identified by using a database from the Western Cape Data Centre. Code-named VECTOR (Virtual Emergency Care Tactical OpeRation), a group of medical officers obtained data from the data centre, which ran an algorithm to generate a list of high-risk PLWD with a COVID-19 diagnosis in a 10-day window.^{13 (link)} These patients were then allocated to the medical officers who contacted them telephonically to offer them elective admission to the HoH.
All 61 patients who accepted admission to the HoH via the telemedicine (VECTOR) community group were included as the experimental group, while 122 purposively selected patients matching the inclusion criteria below in a 2:1 ratio were identified from those admitted prior to the introduction of the intervention (HRDCp) to make up the control group. The two groups were matched for age, gender and renal function.
Inclusion criteria were Type I or II diabetes mellitus with COVID-19 (polymerase chain reaction [PCR] test or clinical diagnosis) and renal impairment (creatinine of more than 100) or age older than or equal to 65 years of age.
Exclusion criteria were age younger than 65 and normal renal function, and for controls, the exclusion criteria were being admitted after the HRDCp was introduced and not being part of the VECTOR cohort.
Renal impairment was defined using the RIFLE (risk, injury, failure, loss of kidney function and end-stage kidney disease) criteria, which included a rise in creatinine, which results in risk, injury, failure, loss of kidney function and end-stage kidney disease (see Appendix 3).^{24 (link)}