Qiao Shi1,2, Xiaoyi Zhang3, Fang Jiang4, Xuanzhe Zhang2, Ning Hu2, Chibu Bimu2, Jiarui Feng5, Su Yan2, Yongjun Guan2, Dongxue Xu3, Guangzhen He6, Chen Chen2, Xingcheng Xiong1, Lei Liu1, Hanjun Li1, Jing Tao1, Zhiyong Peng7, Weixing Wang8. 1. Department of Pancreatic Surgery, Renmin Hospital of Wuhan University, Wuhan, China. 2. Department of General Surgery, Renmin Hospital of Wuhan University, Wuhan, China. 3. Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China. 4. Department of Anesthesiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China. 5. Deparment of Medical Management, Renmin Hospital of Wuhan University, Wuhan, China. 6. Department of Endocrinology, Zhongnan Hospital of Wuhan University, Wuhan, China. 7. Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China pengzy5@hotmail.com sate.llite@163.com. 8. Department of General Surgery, Renmin Hospital of Wuhan University, Wuhan, China pengzy5@hotmail.com sate.llite@163.com.
Abstract
OBJECTIVE: Diabetes is common in COVID-19 patients and associated with unfavorable outcomes. We aimed to describe the characteristics and outcomes and to analyze the risk factors for in-hospital mortality of COVID-19 patients with diabetes. RESEARCH DESIGN AND METHODS: This two-center retrospective study was performed at two tertiary hospitals in Wuhan, China. Confirmed COVID-19 patients with diabetes (N = 153) who were discharged or died from 1 January 2020 to 8 March 2020 were identified. One sex- and age-matched COVID-19 patient without diabetes was randomly selected for each patient with diabetes. Demographic, clinical, and laboratory data were abstracted. Cox proportional hazards regression analyses were performed to identify the risk factors associated with the mortality in these patients. RESULTS: Of 1,561 COVID-19 patients, 153 (9.8%) had diabetes, with a median age of 64.0 (interquartile range 56.0-72.0) years. A higher proportion of intensive care unit admission (17.6% vs. 7.8%, P = 0.01) and more fatal cases (20.3% vs. 10.5%, P = 0.017) were identified in COVID-19 patients with diabetes than in the matched patients. Multivariable Cox regression analyses of these 306 patients showed that hypertension (hazard ratio [HR] 2.50, 95% CI 1.30-4.78), cardiovascular disease (HR 2.24, 95% CI 1.19-4.23), and chronic pulmonary disease (HR 2.51, 95% CI 1.07-5.90) were independently associated with in-hospital death. Diabetes (HR 1.58, 95% CI 0.84-2.99) was not statistically significantly associated with in-hospital death after adjustment. Among patients with diabetes, nonsurvivors were older (76.0 vs. 63.0 years), most were male (71.0% vs. 29.0%), and they were more likely to have underlying hypertension (83.9% vs. 50.0%) and cardiovascular disease (45.2% vs. 14.8%) (all P values <0.05). Age ≥70 years (HR 2.39, 95% CI 1.03-5.56) and hypertension (HR 3.10, 95% CI 1.14-8.44) were independent risk factors for in-hospital death of patients with diabetes. CONCLUSIONS: COVID-19 patients with diabetes had worse outcomes compared with the sex- and age-matched patients without diabetes. Older age and comorbid hypertension independently contributed to in-hospital death of patients with diabetes.
OBJECTIVE:Diabetes is common in COVID-19patients and associated with unfavorable outcomes. We aimed to describe the characteristics and outcomes and to analyze the risk factors for in-hospital mortality of COVID-19patients with diabetes. RESEARCH DESIGN AND METHODS: This two-center retrospective study was performed at two tertiary hospitals in Wuhan, China. Confirmed COVID-19patients with diabetes (N = 153) who were discharged or died from 1 January 2020 to 8 March 2020 were identified. One sex- and age-matched COVID-19patient without diabetes was randomly selected for each patient with diabetes. Demographic, clinical, and laboratory data were abstracted. Cox proportional hazards regression analyses were performed to identify the risk factors associated with the mortality in these patients. RESULTS: Of 1,561 COVID-19patients, 153 (9.8%) had diabetes, with a median age of 64.0 (interquartile range 56.0-72.0) years. A higher proportion of intensive care unit admission (17.6% vs. 7.8%, P = 0.01) and more fatal cases (20.3% vs. 10.5%, P = 0.017) were identified in COVID-19patients with diabetes than in the matched patients. Multivariable Cox regression analyses of these 306 patients showed that hypertension (hazard ratio [HR] 2.50, 95% CI 1.30-4.78), cardiovascular disease (HR 2.24, 95% CI 1.19-4.23), and chronic pulmonary disease (HR 2.51, 95% CI 1.07-5.90) were independently associated with in-hospital death. Diabetes (HR 1.58, 95% CI 0.84-2.99) was not statistically significantly associated with in-hospital death after adjustment. Among patients with diabetes, nonsurvivors were older (76.0 vs. 63.0 years), most were male (71.0% vs. 29.0%), and they were more likely to have underlying hypertension (83.9% vs. 50.0%) and cardiovascular disease (45.2% vs. 14.8%) (all P values <0.05). Age ≥70 years (HR 2.39, 95% CI 1.03-5.56) and hypertension (HR 3.10, 95% CI 1.14-8.44) were independent risk factors for in-hospital death of patients with diabetes. CONCLUSIONS:COVID-19patients with diabetes had worse outcomes compared with the sex- and age-matched patients without diabetes. Older age and comorbid hypertension independently contributed to in-hospital death of patients with diabetes.
Authors: Pandora L Wander; Elliott Lowy; Lauren A Beste; Luis Tulloch-Palomino; Anna Korpak; Alexander C Peterson; Bessie A Young; Edward J Boyko Journal: BMJ Open Diabetes Res Care Date: 2021-06
Authors: Hamid Bolouri; Cate Speake; David Skibinski; S Alice Long; Anne M Hocking; Daniel J Campbell; Jessica A Hamerman; Uma Malhotra; Jane H Buckner Journal: J Clin Invest Date: 2021-02-01 Impact factor: 14.808
Authors: Philip T James; Zakari Ali; Andrew E Armitage; Ana Bonell; Carla Cerami; Hal Drakesmith; Modou Jobe; Kerry S Jones; Zara Liew; Sophie E Moore; Fernanda Morales-Berstein; Helen M Nabwera; Behzad Nadjm; Sant-Rayn Pasricha; Pauline Scheelbeek; Matt J Silver; Megan R Teh; Andrew M Prentice Journal: J Nutr Date: 2021-07-01 Impact factor: 4.798