Phenotypic characteristics and prognosis of inpatients with COVID-19 and diabetes : the CORONADO study
AIMS/HYPOTHESIS: Coronavirus disease-2019 (COVID-19) is a life-threatening infection caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus. Diabetes has rapidly emerged as a major comorbidity for COVID-19 severity. However, the phenotypic characteristics of diabetes in COVID-19 patients are unknown.
METHODS: We conducted a nationwide multicentre observational study in people with diabetes hospitalised for COVID-19 in 53 French centres in the period 10-31 March 2020. The primary outcome combined tracheal intubation for mechanical ventilation and/or death within 7 days of admission. Age- and sex-adjusted multivariable logistic regressions were performed to assess the prognostic value of clinical and biological features with the endpoint. ORs are reported for a 1 SD increase after standardisation.
RESULTS: The current analysis focused on 1317 participants: 64.9% men, mean age 69.8 ± 13.0 years, median BMI 28.4 (25th-75th percentile: 25.0-32.7) kg/m2; with a predominance of type 2 diabetes (88.5%). Microvascular and macrovascular diabetic complications were found in 46.8% and 40.8% of cases, respectively. The primary outcome was encountered in 29.0% (95% CI 26.6, 31.5) of participants, while 10.6% (9.0, 12.4) died and 18.0% (16.0, 20.2) were discharged on day 7. In univariate analysis, characteristics prior to admission significantly associated with the primary outcome were sex, BMI and previous treatment with renin-angiotensin-aldosterone system (RAAS) blockers, but not age, type of diabetes, HbA1c, diabetic complications or glucose-lowering therapies. In multivariable analyses with covariates prior to admission, only BMI remained positively associated with the primary outcome (OR 1.28 [1.10, 1.47]). On admission, dyspnoea (OR 2.10 [1.31, 3.35]), as well as lymphocyte count (OR 0.67 [0.50, 0.88]), C-reactive protein (OR 1.93 [1.43, 2.59]) and AST (OR 2.23 [1.70, 2.93]) levels were independent predictors of the primary outcome. Finally, age (OR 2.48 [1.74, 3.53]), treated obstructive sleep apnoea (OR 2.80 [1.46, 5.38]), and microvascular (OR 2.14 [1.16, 3.94]) and macrovascular complications (OR 2.54 [1.44, 4.50]) were independently associated with the risk of death on day 7.
CONCLUSIONS/INTERPRETATIONS: In people with diabetes hospitalised for COVID-19, BMI, but not long-term glucose control, was positively and independently associated with tracheal intubation and/or death within 7 days.
TRIAL REGISTRATION: clinicaltrials.gov NCT04324736.
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:63 |
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| Enthalten in: |
Diabetologia - 63(2020), 8 vom: 29. Aug., Seite 1500-1515 |
| Sprache: |
Englisch |
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BMI |
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Date Completed 27.07.2020 Date Revised 07.12.2022 published: Print-Electronic ClinicalTrials.gov: NCT04324736 ErratumIn: Diabetologia. 2020 Jul 2;:. - PMID 32617649 Citation Status MEDLINE |
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| doi: |
10.1007/s00125-020-05180-x |
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NLM310526620 |
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| 100 | 1 | |a Cariou, Bertrand |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Phenotypic characteristics and prognosis of inpatients with COVID-19 and diabetes |b the CORONADO study |
| 264 | 1 | |c 2020 | |
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| 500 | |a Date Completed 27.07.2020 | ||
| 500 | |a Date Revised 07.12.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT04324736 | ||
| 500 | |a ErratumIn: Diabetologia. 2020 Jul 2;:. - PMID 32617649 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a AIMS/HYPOTHESIS: Coronavirus disease-2019 (COVID-19) is a life-threatening infection caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus. Diabetes has rapidly emerged as a major comorbidity for COVID-19 severity. However, the phenotypic characteristics of diabetes in COVID-19 patients are unknown | ||
| 520 | |a METHODS: We conducted a nationwide multicentre observational study in people with diabetes hospitalised for COVID-19 in 53 French centres in the period 10-31 March 2020. The primary outcome combined tracheal intubation for mechanical ventilation and/or death within 7 days of admission. Age- and sex-adjusted multivariable logistic regressions were performed to assess the prognostic value of clinical and biological features with the endpoint. ORs are reported for a 1 SD increase after standardisation | ||
| 520 | |a RESULTS: The current analysis focused on 1317 participants: 64.9% men, mean age 69.8 ± 13.0 years, median BMI 28.4 (25th-75th percentile: 25.0-32.7) kg/m2; with a predominance of type 2 diabetes (88.5%). Microvascular and macrovascular diabetic complications were found in 46.8% and 40.8% of cases, respectively. The primary outcome was encountered in 29.0% (95% CI 26.6, 31.5) of participants, while 10.6% (9.0, 12.4) died and 18.0% (16.0, 20.2) were discharged on day 7. In univariate analysis, characteristics prior to admission significantly associated with the primary outcome were sex, BMI and previous treatment with renin-angiotensin-aldosterone system (RAAS) blockers, but not age, type of diabetes, HbA1c, diabetic complications or glucose-lowering therapies. In multivariable analyses with covariates prior to admission, only BMI remained positively associated with the primary outcome (OR 1.28 [1.10, 1.47]). On admission, dyspnoea (OR 2.10 [1.31, 3.35]), as well as lymphocyte count (OR 0.67 [0.50, 0.88]), C-reactive protein (OR 1.93 [1.43, 2.59]) and AST (OR 2.23 [1.70, 2.93]) levels were independent predictors of the primary outcome. Finally, age (OR 2.48 [1.74, 3.53]), treated obstructive sleep apnoea (OR 2.80 [1.46, 5.38]), and microvascular (OR 2.14 [1.16, 3.94]) and macrovascular complications (OR 2.54 [1.44, 4.50]) were independently associated with the risk of death on day 7 | ||
| 520 | |a CONCLUSIONS/INTERPRETATIONS: In people with diabetes hospitalised for COVID-19, BMI, but not long-term glucose control, was positively and independently associated with tracheal intubation and/or death within 7 days | ||
| 520 | |a TRIAL REGISTRATION: clinicaltrials.gov NCT04324736 | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
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| 650 | 4 | |a Mechanical ventilation | |
| 650 | 7 | |a Glycated Hemoglobin A |2 NLM | |
| 650 | 7 | |a hemoglobin A1c protein, human |2 NLM | |
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| 700 | 1 | |a Disse, Emmanuel |e verfasserin |4 aut | |
| 700 | 1 | |a Ducet-Boiffard, Amélie |e verfasserin |4 aut | |
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| 700 | 1 | |a Joubert, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Kerlan, Véronique |e verfasserin |4 aut | |
| 700 | 1 | |a Laviolle, Bruno |e verfasserin |4 aut | |
| 700 | 1 | |a Marchand, Lucien |e verfasserin |4 aut | |
| 700 | 1 | |a Meyer, Laurent |e verfasserin |4 aut | |
| 700 | 1 | |a Potier, Louis |e verfasserin |4 aut | |
| 700 | 1 | |a Prevost, Gaëtan |e verfasserin |4 aut | |
| 700 | 1 | |a Riveline, Jean-Pierre |e verfasserin |4 aut | |
| 700 | 1 | |a Robert, René |e verfasserin |4 aut | |
| 700 | 1 | |a Saulnier, Pierre-Jean |e verfasserin |4 aut | |
| 700 | 1 | |a Sultan, Ariane |e verfasserin |4 aut | |
| 700 | 1 | |a Thébaut, Jean-François |e verfasserin |4 aut | |
| 700 | 1 | |a Thivolet, Charles |e verfasserin |4 aut | |
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