Adverse outcomes in COVID-19 and diabetes : a retrospective cohort study from three London teaching hospitals
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ..
INTRODUCTION: Patients with diabetes mellitus admitted to hospital with COVID-19 have poorer outcomes. However, the drivers of poorer outcomes are not fully elucidated. We performed detailed characterization of patients with COVID-19 to determine the clinical and biochemical factors that may be drivers of poorer outcomes.
RESEARCH DESIGN AND METHODS: This is a retrospective cohort study of 889 consecutive inpatients diagnosed with COVID-19 between March 9 and April 22, 2020 in a large London National Health Service Trust. Unbiased multivariate logistic regression analysis was performed to determine variables that were independently and significantly associated with increased risk of death and/or intensive care unit (ICU) admission within 30 days of COVID-19 diagnosis.
RESULTS: 62% of patients in our cohort were of non-white ethnic background and the prevalence of diabetes was 38%. 323 (36%) patients met the primary outcome of death/admission to the ICU within 30 days of COVID-19 diagnosis. Male gender, lower platelet count, advancing age and higher Clinical Frailty Scale (CFS) score (but not diabetes) independently predicted poor outcomes on multivariate analysis. Antiplatelet medication was associated with a lower risk of death/ICU admission. Factors that were significantly and independently associated with poorer outcomes in patients with diabetes were coexisting ischemic heart disease, increasing age and lower platelet count.
CONCLUSIONS: In this large study of a diverse patient population, comorbidity (ie, diabetes with ischemic heart disease; increasing CFS score in older patients) was a major determinant of poor outcomes with COVID-19. Antiplatelet medication should be evaluated in randomized clinical trials among high-risk patient groups.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:9 |
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| Enthalten in: |
BMJ open diabetes research & care - 9(2021), 1 vom: 06. Jan. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Izzi-Engbeaya, Chioma [VerfasserIn] |
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| Links: |
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| Themen: |
Infections |
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| Anmerkungen: |
Date Completed 15.01.2021 Date Revised 10.11.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1136/bmjdrc-2020-001858 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM319718417 |
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| 100 | 1 | |a Izzi-Engbeaya, Chioma |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Adverse outcomes in COVID-19 and diabetes |b a retrospective cohort study from three London teaching hospitals |
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| 500 | |a Date Completed 15.01.2021 | ||
| 500 | |a Date Revised 10.11.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. | ||
| 520 | |a INTRODUCTION: Patients with diabetes mellitus admitted to hospital with COVID-19 have poorer outcomes. However, the drivers of poorer outcomes are not fully elucidated. We performed detailed characterization of patients with COVID-19 to determine the clinical and biochemical factors that may be drivers of poorer outcomes | ||
| 520 | |a RESEARCH DESIGN AND METHODS: This is a retrospective cohort study of 889 consecutive inpatients diagnosed with COVID-19 between March 9 and April 22, 2020 in a large London National Health Service Trust. Unbiased multivariate logistic regression analysis was performed to determine variables that were independently and significantly associated with increased risk of death and/or intensive care unit (ICU) admission within 30 days of COVID-19 diagnosis | ||
| 520 | |a RESULTS: 62% of patients in our cohort were of non-white ethnic background and the prevalence of diabetes was 38%. 323 (36%) patients met the primary outcome of death/admission to the ICU within 30 days of COVID-19 diagnosis. Male gender, lower platelet count, advancing age and higher Clinical Frailty Scale (CFS) score (but not diabetes) independently predicted poor outcomes on multivariate analysis. Antiplatelet medication was associated with a lower risk of death/ICU admission. Factors that were significantly and independently associated with poorer outcomes in patients with diabetes were coexisting ischemic heart disease, increasing age and lower platelet count | ||
| 520 | |a CONCLUSIONS: In this large study of a diverse patient population, comorbidity (ie, diabetes with ischemic heart disease; increasing CFS score in older patients) was a major determinant of poor outcomes with COVID-19. Antiplatelet medication should be evaluated in randomized clinical trials among high-risk patient groups | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a infections | |
| 650 | 4 | |a type 1 diabetes mellitus | |
| 650 | 4 | |a type 2 diabetes mellitus | |
| 650 | 4 | |a viruses | |
| 700 | 1 | |a Distaso, Walter |e verfasserin |4 aut | |
| 700 | 1 | |a Amin, Anjali |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Wei |e verfasserin |4 aut | |
| 700 | 1 | |a Idowu, Oluwagbemiga |e verfasserin |4 aut | |
| 700 | 1 | |a Kenkre, Julia S |e verfasserin |4 aut | |
| 700 | 1 | |a Shah, Ronak J |e verfasserin |4 aut | |
| 700 | 1 | |a Woin, Evelina |e verfasserin |4 aut | |
| 700 | 1 | |a Shi, Christine |e verfasserin |4 aut | |
| 700 | 1 | |a Alavi, Nael |e verfasserin |4 aut | |
| 700 | 1 | |a Bedri, Hala |e verfasserin |4 aut | |
| 700 | 1 | |a Brady, Niamh |e verfasserin |4 aut | |
| 700 | 1 | |a Blackburn, Sophie |e verfasserin |4 aut | |
| 700 | 1 | |a Leczycka, Martina |e verfasserin |4 aut | |
| 700 | 1 | |a Patel, Sanya |e verfasserin |4 aut | |
| 700 | 1 | |a Sokol, Elizaveta |e verfasserin |4 aut | |
| 700 | 1 | |a Toke-Bjolgerud, Edward |e verfasserin |4 aut | |
| 700 | 1 | |a Qayum, Ambreen |e verfasserin |4 aut | |
| 700 | 1 | |a Abdel-Malek, Mariana |e verfasserin |4 aut | |
| 700 | 1 | |a Hope, David C D |e verfasserin |4 aut | |
| 700 | 1 | |a Oliver, Nick S |e verfasserin |4 aut | |
| 700 | 1 | |a Bravis, Vasiliki |e verfasserin |4 aut | |
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| 700 | 1 | |a Tan, Tricia M |e verfasserin |4 aut | |
| 700 | 1 | |a Hill, Neil E |e verfasserin |4 aut | |
| 700 | 1 | |a Salem, Victoria |e verfasserin |4 aut | |
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