EFFECT OF COVID-19 PANDEMIC ON LIVER ABSCESS ASSOCIATED WITH TYPE 2 DIABETES MELLITUS

Jiyao Ding¹, Wenhua Chen², Hongjian Shi³, Xinhua Ye⁴, Feng Zhang⁵, Tao Wang⁶, Zhongzhi Jia⁷

¹Department of Nephrology, The Third Affiliated Hospital of Soochow University, Changzhou, China, 213000 - ²Department of Interventional Radiology, The Third Affiliated Hospital of Soochow University, Changzhou, China, 213000 - ³Department of Interventional Radiology, Wujin people's Hospital, Jiangsu University, Changzhou, China, 213003 - ⁴Department of Endocrinology, Changzhou No. 2 People's Hospital, Changzhou, China, 213003 - ₅Department of Information Technology, Changzhou No. 2 People's Hospital, Changzhou, China, 213003 - ⁶Department of Radiology, Changzhou No. 2 People's Hospital, Changzhou, China, 213003 - ⁷Department of Interventional Radiology, Changzhou No. 2 People's Hospital, Changzhou, China, 213003

Objective: To investigate the effect of the coronavirus disease 2019 (COVID-19) pandemic on patients with liver abscess associated with type 2 diabetes mellitus (T2DM).

Methods: Data about consecutive cases of T2DM-associated liver abscess diagnosed and treated during the pandemic (January-April 2020) or earlier (January-April in 2017-2019) were compared.

Results: A total of 177 patients (122 men; median age, 66 years; 124 treated in 2017-2019 and 53 treated in 2020) were included in the study. Antibiotic therapy alone led to abscess resolution in 75 patients; the remaining 102 patients underwent successful abscess aspiration (n=56) or drain placement (n = 46). The mean random plasma glucose (15.9±2.7 vs 12.7±2.7 mmol/L; P<0.001), fasting plasma glucose (11.4±2.0 vs 10.6±2.0 mmol/L; P=0.017), and glycosylated hemoglobin A1c (9.1%±1.5% vs 7.8%±0.9%; P<0.001) levels at the presentation were higher among patients treated in 2020 than among those treated earlier. The mean interval between symptom onset and presentation was shorter for patients treated in 2020 (36.5±7.2 hours) than for those treated earlier (50.4±17.4 hours; P<0.001). The mean interval between presentation and diagnosis was longer among patients treated in 2020 (18.4±9.9 hours) than among those treated earlier (11.3±4.9 hours; P<0.001).

Conclusions: The COVID-19 pandemic may have promoted the occurrence of liver abscess among patients with poorly controlled T2DM, and control measures for the pandemic may have led to delays in diagnosis.