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Adverse outcomes in COVID-19 and diabetes: a retrospective cohort study from three London teaching hospitals.
Izzi-Engbeaya, Chioma; Distaso, Walter; Amin, Anjali; Yang, Wei; Idowu, Oluwagbemiga; Kenkre, Julia S; Shah, Ronak J; Woin, Evelina; Shi, Christine; Alavi, Nael; Bedri, Hala; Brady, Niamh; Blackburn, Sophie; Leczycka, Martina; Patel, Sanya; Sokol, Elizaveta; Toke-Bjolgerud, Edward; Qayum, Ambreen; Abdel-Malek, Mariana; Hope, David C D; Oliver, Nick S; Bravis, Vasiliki; Misra, Shivani; Tan, Tricia M; Hill, Neil E; Salem, Victoria.
Afiliación
  • Izzi-Engbeaya C; Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, London, UK.
  • Distaso W; Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
  • Amin A; Imperial College Business School, Imperial College London, London, UK.
  • Yang W; Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, London, UK.
  • Idowu O; Department of Clinical Biochemistry, Imperial College Healthcare NHS Trust, London, UK.
  • Kenkre JS; Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, London, UK.
  • Shah RJ; Department of Clinical Biochemistry, Imperial College Healthcare NHS Trust, London, UK.
  • Woin E; Division of Medicine and Integrated Care, Imperial College Healthcare NHS Trust, London, UK.
  • Shi C; Division of Medicine and Integrated Care, Imperial College Healthcare NHS Trust, London, UK.
  • Alavi N; Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, London, UK.
  • Bedri H; Division of Medicine and Integrated Care, Imperial College Healthcare NHS Trust, London, UK.
  • Brady N; Division of Medicine and Integrated Care, Imperial College Healthcare NHS Trust, London, UK.
  • Blackburn S; Division of Medicine and Integrated Care, Imperial College Healthcare NHS Trust, London, UK.
  • Leczycka M; Division of Medicine and Integrated Care, Imperial College Healthcare NHS Trust, London, UK.
  • Patel S; Division of Medicine and Integrated Care, Imperial College Healthcare NHS Trust, London, UK.
  • Sokol E; Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, London, UK.
  • Toke-Bjolgerud E; Division of Medicine and Integrated Care, Imperial College Healthcare NHS Trust, London, UK.
  • Qayum A; Division of Medicine and Integrated Care, Imperial College Healthcare NHS Trust, London, UK.
  • Abdel-Malek M; Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, London, UK.
  • Hope DCD; Department of Clinical Biochemistry, Imperial College Healthcare NHS Trust, London, UK.
  • Oliver NS; Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
  • Bravis V; Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, London, UK.
  • Misra S; Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
  • Tan TM; Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, London, UK.
  • Hill NE; Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, London, UK.
  • Salem V; Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
BMJ Open Diabetes Res Care ; 9(1)2021 01.
Article en En | MEDLINE | ID: mdl-33408084
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diabetes Mellitus / Fragilidad / COVID-19 / Unidades de Cuidados Intensivos Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: BMJ Open Diabetes Res Care Año: 2021 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diabetes Mellitus / Fragilidad / COVID-19 / Unidades de Cuidados Intensivos Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: BMJ Open Diabetes Res Care Año: 2021 Tipo del documento: Article Pais de publicación: Reino Unido