1358-P: Point of Care OGTT for the Screening of Gestational Diabetes: A Feasible Proposal for Low-Resource Settings

Due to the ubiquity of risk factors associated with gestational diabetes (GDM) in Mexican women and the low availability of the Oral Glucose Tolerance Test (OGTT), we compared the efficacy of two point of care (POC) models for GDM detection against the plasmatic 2hr OGTT-75gr in primary health care clinics in Mexico. We evaluated 328 pregnant women without previous diabetes diagnosis from a prospective cohort study “Cuido mi embarazo”; all of them were tested with the gold standard plasmatic 2hr OGTT-75gr for the diagnosis of GDM based on the ADA 2019 criteria. Simultaneously, we measured with a glucometer (ACCU-CHEK instant®) the glucose concentration either by capillary whole blood (172 measures) or from venous whole blood (156 measures). We evaluated the diagnostic accuracy by calculating the sensitivity, specificity, and ROC curve of each of the glucometer test results compared to the plasmatic test. For the first model, POC venous OGTT, the incidence of GDM was 41.66% compared to 7.05% of the plasmatic test. The ROC area under the curve for GDM prediction was 0.81 (95% CI 0.77-0.85), with a sensitivity of 100% and specificity of 62.8%. The low specificity is dependent on the fasting venous value of 64% since it was compared to 95% and 97% specificity of the 1hr and 2hr values, respectively. The second model, POC capillary OGTT, had an incidence of GDM of 30.23% compared to 8.13% of the plasmatic test. It had lower sensitivity (78.57%) and higher specificity (74.1%) compared to the first model, having an overall 0.76 (95% CI 0.65-0.88) ROC area under the curve for GDM prediction. We propose POC venous OGTT as a feasible diagnostic alternative for low resource settings where laboratory infrastructure is not available. Its positive bias could be beneficial since the treatment and control of early cases is related to better health outcomes for the moms and their babies. Further analysis is needed to improve GDM, POC screening interventions. Disclosure H. Gallardo: None. J. Lomelin-Gascon: Other Relationship; Self; Lilly Global Health Partnership. L.A. Martinez: Other Relationship; Self; Lilly Global Health Partnership. A. Montoya: None. E. Reyes-Muñoz: None. R.C. Tapia-Conyer: None. Funding Eli Lilly and Company </jats:sec

1068-P: Diabetes and Comorbidities Risk Assessment in Hospitalization and Fatalities from the Mexican COVID-19 Surveillance System

The SARS-CoV-2 outbreak poses a challenge to the Mexican health care system due to its high complication and lethality rates in patients with diabetes and comorbidities. Here, we evaluate the association among diabetes and main comorbidities [obesity, hypertension and chronic kidney disease (CKD)] on COVID-19 outcomes (prevalence, hospitalization, lethality and hospital fatality) in Mexican population. We used available public data released by the Mexican COVID-19 surveillance system (MC-19SS) from January 1st to December 31st of 2020. All 3,401,172 records of SARS-CoV-2 suspected population over or equal to 20 years old were included, out of whom 1,384,470 tested positive. Multiple logistic regression models were fitted to assess the risk over several outcomes (hospitalization and fatality), with self-reported diabetes and comorbidities in confirmed cases, adjusting for age, sex, smoking status and marginalization of the place of residence. Overall population tested, 399,953 (11.8%) subjects had diabetes. Of them, 47.8% also had hypertension, 9.0% obesity and 7.0% CKD. Patients who tested positive to COVID-19 had a higher proportion of diabetes (14.7%). From the 203,310 COVID-19 positive patients with diabetes, 95,225(46.8%) were hospitalized and of those 45,128(47.4%) died; also 4,701 died without had been hospitalized. People with diabetes had significant (p&amp;lt;.005) higher odds of hospitalization OR:2.2, hospital 1.27 and non-hospital 1.98 fatality. Nevertheless, subjects with diabetes and other chronic disease experience higher rates of several outcomes. Diabetes and CKD had the highest odds of hospitalization 7.3 died in hospital (2.14) or out of hospital (6.5) compared with cases without diabetes. This analysis points out that diabetes contributes to the risk of infection and worse outcomes for those infected by SARS-CoV-2. More must be done to combat and prevent diabetes and comorbidities to reduce the burden of COVID-19. Disclosure H. Gallardo-rincón: None. A. Montoya: None. L. Martinez-juarez: Research Support; Self; Lilly Global Health Partnership. J. Lomelin-gascon: None. E. R. Saucedo-martinez: None. R. Mujica-rosales: None. R. Tapia-conyer: None

Symptom cluster analysis of long COVID-19 in patients discharged from the Temporary COVID-19 Hospital in Mexico City.

INTRODUCTION: Several reports have emerged describing the long-term consequences of COVID-19 and its effects on multiple systems. METHODS: As further research is needed, we conducted a longitudinal observational study to report the prevalence and associated risk factors of the long-term health consequences of COVID-19 by symptom clusters in patients discharged from the Temporary COVID-19 Hospital (TCH) in Mexico City. Self-reported clinical symptom data were collected via telephone calls over 90 days post-discharge. Among 4670 patients, we identified 45 symptoms across eight symptom clusters (neurological; mood disorders; systemic; respiratory; musculoskeletal; ear, nose, and throat; dermatological; and gastrointestinal). RESULTS: We observed that the neurological, dermatological, and mood disorder symptom clusters persisted in >30% of patients at 90 days post-discharge. Although most symptoms decreased in frequency between day 30 and 90, alopecia and the dermatological symptom cluster significantly increased (p < 0.00001). Women were more prone than men to develop long-term symptoms, and invasive mechanical ventilation also increased the frequency of symptoms at 30 days post-discharge. CONCLUSION: Overall, we observed that symptoms often persisted regardless of disease severity. We hope these findings will help promote public health strategies that ensure equity in the access to solutions focused on the long-term consequences of COVID-19