Coagulopathy is a major extrapulmonary risk factor for mortality in hospitalized patients with COVID-19 with type 2 diabetes

Introduction To investigate the risk factors for the death in patients with COVID-19 with type 2 diabetes mellitus (T2DM).Research design and methods We retrospectively enrolled inpatients with COVID-19 from Wuhan Jinyintan Hospital (Wuhan, China) between December 25, 2019, and March 3, 2020. The epidemiological and clinical data were compared between non-T2DM and T2DM or between survivors and non-survivors. Univariable and multivariable Cox regression analyses were used to explore the effect of T2DM and complications on in-hospital death.Results A total of 1105 inpatients with COVID-19, 967 subjects with without T2DM (n=522 male, 54.0%) and 138 subjects with pre-existing T2DM (n=82 male, 59.4%) were included for baseline characteristics analyses. The complications were also markedly increased in patients with pre-existing T2DM, including acute respiratory distress syndrome (ARDS) (48.6% vs 32.3%, p<0.001), acute cardiac injury (ACI) (36.2% vs 16.7%, p<0.001), acute kidney injury (AKI) (24.8% vs 9.5%, p<0.001), coagulopathy (24.8% vs 11.1%, p<0.001), and hypoproteinemia (21.2% vs 9.4%, p<0.001). The in-hospital mortality was significantly higher in patients with pre-existing T2DM compared with those without T2DM (35.3% vs 17.4%, p<0.001). Moreover, in hospitalized patients with COVID-19 with T2DM, ARDS and coagulopathy were the main causes of mortality, with an HR of 7.96 (95% CI 2.25 to 28.24, p=0.001) for ARDS and an HR of 2.37 (95% CI 1.08 to 5.21, p=0.032) for coagulopathy. This was different from inpatients with COVID-19 without T2DM, in whom ARDS and cardiac injury were the main causes of mortality, with an HR of 12.18 (95% CI 5.74 to 25.89, p<0.001) for ARDS and an HR of 4.42 (95% CI 2.73 to 7.15, p<0.001) for cardiac injury.Conclusions Coagulopathy was a major extrapulmonary risk factor for death in inpatients with COVID-19 with T2DM rather than ACI and AKI, which were well associated with mortality in inpatients with COVID-19 without T2DM..

Medienart:	E-Artikel

Erscheinungsjahr:	2020
Erschienen:	2020

Enthalten in:	Zur Gesamtaufnahme - volume:8
Enthalten in:	BMJ Open Diabetes Research & Care - 8(2020), 2

Sprache:	Englisch

Beteiligte Personen:	Ying Chen [VerfasserIn] Jie Xu [VerfasserIn] Xiaoyan Chen [VerfasserIn] Chaomin Wu [VerfasserIn] Ming Wei [VerfasserIn] Yen-cheng Chao [VerfasserIn] Juan Song [VerfasserIn] Dongni Hou [VerfasserIn] Yuye Zhang [VerfasserIn] Chunling Du [VerfasserIn] Xiaoying Li [VerfasserIn] Yuanlin Song [VerfasserIn]

Links:	doi.org [kostenfrei] doaj.org [kostenfrei] drc.bmj.com [kostenfrei] Journal toc [kostenfrei]

Themen:	Diseases of the endocrine glands. Clinical endocrinology

doi:	10.1136/bmjdrc-2020-001851

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	DOAJ062448048