Predictors of mortality in critically ill patients with COVID-19 and diabetes
Rev. bras. pesqui. méd. biol
; Braz. j. med. biol. res;56: e12728, 2023. tab, graf
Article
em En
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LILACS-Express
| LILACS
| ID: biblio-1505876
Biblioteca responsável:
BR1.1
ABSTRACT
The COVID-19 pandemic has challenged the entire world, and patients with diabetes mellitus (DM) have been particularly affected. We aimed to evaluate predictors of mortality during the first 30 days of hospitalization in critically ill patients with COVID-19 and comorbid DM. This prospective study included 110 critically ill patients admitted with COVID-19 infection. Thirty-two (29%) patients had a previous diagnosis of DM. Clinical variables, laboratory tests, and vascular biomarkers, such as VCAM-1, syndecan-1, ICAM-1, angiopoietin-1, and angiopoeitin-2, were evaluated after intensive care unit (ICU) admission. A comparison was made between patients with and without DM. No difference in mortality was observed between the groups (48.7 vs 46.9%, P=0.861). In the multivariate Cox regression analysis, VCAM-1 levels at ICU admission (HR 1 [1-1.001], P<0.006) were associated with death in patients with DM. Among patients with DM, advanced age (HR 1.063 [1.031-1.096], P<0.001), increased Ang-2/Ang-1 ratio (HR 4.515 [1.803-11.308] P=0.001), and need for dialysis (HR 3.489 [1.409-8.642], P=0.007) were independent predictors of death. Higher levels of VCAM-1 in patients with DM was better at predicting death of patients with severe COVID-19 and comorbid DM, and their cut-off values were useful for stratifying patients with a worse prognosis. Vascular biomarkers VCAM-1 and Ang-2/Ang-1 ratio were predictors of death in patients with severe COVID-19 and comorbid DM and those without DM. Additionally, kidney injury was associated with an increased risk of death.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
LILACS
Tipo de estudo:
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Idioma:
En
Revista:
Braz. j. med. biol. res
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Rev. bras. pesqui. méd. biol
Assunto da revista:
BIOLOGIA
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MEDICINA
Ano de publicação:
2023
Tipo de documento:
Article
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Project document
País de afiliação:
Brasil
País de publicação:
Brasil