Jose Manuel Ramos-Rincón1, Luis M Pérez-Belmonte2, Francisco Javier Carrasco-Sánchez3, Sergio Jansen-Chaparro2, Mercedes De-Sousa-Baena3, José Bueno-Fonseca2, Maria Pérez-Aguilar3, Coral Arévalo-Cañas4, Marta Bacete Cebrian5, Manuel Méndez-Bailón6, Isabel Fiteni Mera7, Andrés González García8, Francisco Navarro Romero9, Carlota Tuñón de Almeida10, Gemma Muñiz Nicolás11, Amara González Noya12, Almudena Hernández Milian13, Gema María García García14, José Nicolás Alcalá Pedrajas15, Virginia Herrero García16, Luis Corral-Gudino17, Pere Comas Casanova18, Héctor Meijide Míguez19, José Manuel Casas-Rojo20, Ricardo Gómez-Huelgas2. 1. Department of Clinical Medicine, Miguel Hernandez University of Elche, Alicante, Spain. 2. Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), Spain. 3. Internal Medicine Department, Juan Ramón Jiménez University Hospital, Huelva, Spain. 4. Internal Medicine Department, 12 de Octubre University Hospital, Madrid, Spain. 5. Internal Medicine Department, Gregorio Marañon University Hospital, Madrid, Spain. 6. Internal Medicine Department, San Carlos Clinical Hospital, Complutense University, Madrid, Spain. 7. Internal Medicine Department, Royo Villanova Hospital, Zaragoza, Spain. 8. Internal Medicine Department, Ramón y Cajal University Hospital, Madrid, Spain. 9. Internal Medicine Department, Costa del Sol Hospital, Marbella, Spain. 10. Internal Medicine Department, Zamora Hospital Complex, Spain. 11. Internal Medicine Department, Virgen de la Salud Hospital, Toledo, Spain. 12. Internal Medicine Department, Ourense University Hospital Complex, Spain. 13. Internal Medicine Department, Son Llàtzer University Hospital, Palma de Mallorca, Spain. 14. Internal Medicine Department, Badajoz University Hospital Complex, Spain. 15. Internal Medicine Department, Pozoblanco Hospital, Spain. 16. Internal Medicine Department, Doctor José Molina Orosa Hospital, Arrecife, Spain. 17. Internal Medicine Department, Río Hortega University Hospital, Regional Health Management of Castilla y Leon (SACYL), Valladolid University, Spain. 18. Internal Medicine Department, Blanes Hospital, Spain. 19. Internal Medicine Department, Quironsalud A Coruña Hospital, Spain. 20. Internal Medicine Department, Infanta Cristina University Hospital, Madrid, Spain.
Abstract
BACKGROUND: The effects of cardiometabolic drugs on the prognosis of diabetic patients with COVID-19, especially very old patients, are not well known. This work was aimed to analyze the association between preadmission cardiometabolic therapy (antidiabetic, antiaggregant, antihypertensive, and lipid-lowering drugs) and in-hospital mortality among patients ≥80 years with type 2 diabetes mellitus (T2DM) hospitalized for COVID-19. METHOD: We conducted a nationwide, multicenter, observational study in patients ≥80 years with T2DM hospitalized for COVID-19 between March 1 and May 29, 2020. The primary outcome measure was in-hospital mortality. A multivariate logistic regression analysis was performed to assess the association between preadmission cardiometabolic therapy and in-hospital mortality. RESULTS: Of the 2 763 patients ≥80 years old hospitalized due to COVID-19, 790 (28.6%) had T2DM. Of these patients, 385 (48.7%) died during admission. On the multivariate analysis, the use of dipeptidyl peptidase-4 inhibitors (adjusted odds ratio [AOR] 0.502, 95% confidence interval [CI]: 0.309-0.815, p = .005) and angiotensin receptor blockers (AOR 0.454, 95% CI: 0.274-0.759, p = .003) were independent protectors against in-hospital mortality, whereas the use of acetylsalicylic acid was associated with higher in-hospital mortality (AOR 1.761, 95% CI: 1.092-2.842, p = .020). Other antidiabetic drugs, angiotensin-converting enzyme inhibitors, and statins showed neutral association with in-hospital mortality. CONCLUSIONS: We found important differences between cardiometabolic drugs and in-hospital mortality in older patients with T2DM hospitalized for COVID-19. Preadmission treatment with dipeptidyl peptidase-4 inhibitors and angiotensin receptor blockers could reduce in-hospital mortality; other antidiabetic drugs, angiotensin-converting enzyme inhibitors, and statins seem to have a neutral effect; and acetylsalicylic acid could be associated with excess mortality.
BACKGROUND: The effects of cardiometabolic drugs on the prognosis of diabeticpatients with COVID-19, especially very old patients, are not well known. This work was aimed to analyze the association between preadmission cardiometabolic therapy (antidiabetic, antiaggregant, antihypertensive, and lipid-lowering drugs) and in-hospital mortality among patients ≥80 years with type 2 diabetes mellitus (T2DM) hospitalized for COVID-19. METHOD: We conducted a nationwide, multicenter, observational study in patients ≥80 years with T2DM hospitalized for COVID-19 between March 1 and May 29, 2020. The primary outcome measure was in-hospital mortality. A multivariate logistic regression analysis was performed to assess the association between preadmission cardiometabolic therapy and in-hospital mortality. RESULTS: Of the 2 763 patients ≥80 years old hospitalized due to COVID-19, 790 (28.6%) had T2DM. Of these patients, 385 (48.7%) died during admission. On the multivariate analysis, the use of dipeptidyl peptidase-4 inhibitors (adjusted odds ratio [AOR] 0.502, 95% confidence interval [CI]: 0.309-0.815, p = .005) and angiotensin receptor blockers (AOR 0.454, 95% CI: 0.274-0.759, p = .003) were independent protectors against in-hospital mortality, whereas the use of acetylsalicylic acid was associated with higher in-hospital mortality (AOR 1.761, 95% CI: 1.092-2.842, p = .020). Other antidiabetic drugs, angiotensin-converting enzyme inhibitors, and statins showed neutral association with in-hospital mortality. CONCLUSIONS: We found important differences between cardiometabolic drugs and in-hospital mortality in older patients with T2DM hospitalized for COVID-19. Preadmission treatment with dipeptidyl peptidase-4 inhibitors and angiotensin receptor blockers could reduce in-hospital mortality; other antidiabetic drugs, angiotensin-converting enzyme inhibitors, and statins seem to have a neutral effect; and acetylsalicylic acid could be associated with excess mortality.
Authors: Giuseppe De Luca; Matteo Nardin; Magdy Algowhary; Berat Uguz; Dinaldo C Oliveira; Vladimir Ganyukov; Zan Zimbakov; Miha Cercek; Lisette Okkels Jensen; Poay Huan Loh; Lucian Calmac; Gerard Roura Ferrer; Alexandre Quadros; Marek Milewski; Fortunato Scotto di Uccio; Clemens von Birgelen; Francesco Versaci; Jurrien Ten Berg; Gianni Casella; Aaron Wong Sung Lung; Petr Kala; José Luis Díez Gil; Xavier Carrillo; Maurits Dirksen; Victor M Becerra-Munoz; Michael Kang-Yin Lee; Dafsah Arifa Juzar; Rodrigo de Moura Joaquim; Roberto Paladino; Davor Milicic; Periklis Davlouros; Nikola Bakraceski; Filippo Zilio; Luca Donazzan; Adriaan Kraaijeveld; Gennaro Galasso; Arpad Lux; Lucia Marinucci; Vincenzo Guiducci; Maurizio Menichelli; Alessandra Scoccia; Aylin Hatice Yamac; Kadir Ugur Mert; Xacobe Flores Rios; Tomas Kovarnik; Michal Kidawa; Josè Moreu; Vincent Flavien; Enrico Fabris; Iñigo Lozano Martínez-Luengas; Marco Boccalatte; Francisco Bosa Ojeda; Carlos Arellano-Serrano; Gianluca Caiazzo; Giuseppe Cirrincione; Hsien-Li Kao; Juan Sanchis Forés; Luigi Vignali; Helder Pereira; Stephane Manzo; Santiago Ordoñez; Alev Arat Özkan; Bruno Scheller; Heidi Lehtola; Rui Teles; Christos Mantis; Ylitalo Antti; João António Brum Silveira; Rodrigo Zoni; Ivan Bessonov; Stefano Savonitto; George Kochiadakis; Dimitrios Alexopulos; Carlos E Uribe; John Kanakakis; Benjamin Faurie; Gabriele Gabrielli; Alejandro Gutierrez Barrios; Juan Pablo Bachini; Alex Rocha; Frankie Chor-Cheung Tam; Alfredo Rodriguez; Antonia Anna Lukito; Veauthyelau Saint-Joy; Gustavo Pessah; Andrea Tuccillo; Giuliana Cortese; Guido Parodi; Mohammed Abed Bouraghda; Elvin Kedhi; Pablo Lamelas; Harry Suryapranata; Monica Verdoia Journal: Diabet Epidemiol Manag Date: 2021-10-30