Early identification of severe patients with coronavirus disease 2019 (COVID-19) is very important for individual treatment. We included 203 patients with COVID-19 by propensity score matching in this retrospective, case-control study. The effects of serum lactate dehydrogenase (LDH) at admission on patients with COVID-19 were evaluated. We found that serum LDH levels had a 58.7% sensitivity and 82.0% specificity, based on a best cut-off of 277.00 U/L, for predicting severe COVID-19. And a cut-off of 359.50 U/L of the serum LDH levels resulted in a 93.8% sensitivity, 88.2% specificity for predicting death of COVID-19. Additionally, logistic regression analysis and Cox proportional hazards model respectively indicated that elevated LDH level was an independent risk factor for the severity (HR: 2.73, 95% CI: 1.25-5.97; P=0.012) and mortality (HR: 40.50, 95% CI: 3.65-449.28; P=0.003) of COVID-19. Therefore, elevated LDH level at admission is an independent risk factor for the severity and mortality of COVID-19. LDH can assist in the early evaluating of COVID-19. Clinicians should pay attention to the serum LDH level at admission for patients with COVID-19.

BACKGROUND Previous studies have shown that diabetes mellitus is a common comorbidity of coronavirus disease 2019 (COVID-19), but the effects of diabetes or anti-diabetic medication on the mortality of COVID-19 have not been well described. AIM To investigate the outcome of different statuses (with or without comorbidity) and anti-diabetic medication use before admission of diabetic after COVID-19. METHODS In this multicenter and retrospective study, we enrolled 1422 consecutive hospitalized patients from January 21, 2020, to March 25, 2020, at six hospitals in Hubei Province, China. The primary endpoint was in-hospital mortality. Epidemiological material, demographic information, clinical data, laboratory parameters, radiographic characteristics, treatment and outcome were extracted from electronic medical records using a standardized data collection form. Most of the laboratory data except fasting plasma glucose (FPG) were obtained in first hospitalization, and FPG was collected in the next day morning. Major clinical symptoms, vital signs at admission and comorbidities were collected. The treatment data included not only COVID-19 but also diabetes mellitus. The duration from the onset of symptoms to admission, illness severity, intensive care unit (ICU) admission, and length of hospital stay were also recorded. All data were checked by a team of sophisticated physicians. RESULTS Patients with diabetes were 10 years older than non-diabetic patients [(39 - 64) vs (56 - 70), P < 0.001] and had a higher prevalence of comorbidities such as hypertension (55.5% vs 21.4%, P < 0.001), coronary heart disease (CHD) (9.9% vs 3.5%, P < 0.001), cerebrovascular disease (CVD) (3% vs 2.2%, P < 0.001), and chronic kidney disease (CKD) (4.7% vs 1.5%, P = 0.007). Mortality (13.6% vs 7.2%, P = 0.003) was more prevalent among the diabetes group. Further analysis revealed that patients with diabetes who took acarbose had a lower mortality rate (2.2% vs 26.1, P < 0.01). Multivariable Cox regression showed that male sex [hazard ratio (HR) 2.59 (1.68 - 3.99), P < 0.001], hypertension [HR 1.75 (1.18 - 2.60), P = 0.006), CKD [HR 4.55 (2.52-8.20), P < 0.001], CVD [HR 2.35 (1.27 - 4.33), P = 0.006], and age were risk factors for the COVID-19 mortality. Higher HRs were noted in those aged ≥ 65 (HR 11.8 [4.6 - 30.2], P < 0.001) vs 50-64 years (HR 5.86 [2.27 - 15.12], P < 0.001). The...

Background Although chronic cardio‐metabolic disease is a common comorbidity among patients with COVID‐19, its effects on the clinical characteristics and outcome are not well known. Methods and Results This study aimed to explore the association between underlying cardio‐metabolic disease and mortality with COVID‐19 among hospitalized patients. This multicenter, retrospective, and real‐world study was conducted from January 22, 2020 to March 25, 2020 in China. Data between patients with and without 5 main cardio‐metabolic diseases including hypertension, diabetes mellitus, coronary heart disease, cerebrovascular disease, and hyperlipidemia were compared. A total of 1303 hospitalized patients were included in the final analysis. Of them, 520 patients (39.9%) had cardio‐metabolic disease. Compared with patients without cardio‐metabolic disease, more patients with cardio‐metabolic disease had COVID‐related complications including acute respiratory distress syndrome (9.81% versus 3.32%; P <0.001), acute kidney injury (4.23% versus 1.40%; P= 0.001), secondary infection (13.9% versus 9.8%; P= 0.026), hypoproteinemia (12.1% versus 5.75%; P <0.001), and coagulopathy (19.4% versus 10.3%; P <0.001), had higher incidences of the severe type of COVID‐19 (32.9% versus 16.7%; P <0.001), more were admitted to the intensive care unit (11.7% versus 7.92%; P= 0.021), and required mechanical ventilation (9.8% versus 4.3%; P <0.001). When the number of the patients' cardio‐metabolic diseases was 0, 1, and >2, the mortality was 4.2%, 11.1%, and 19.8%, respectively. The multivariable‐adjusted hazard ratio of mortality among patients with cardio‐metabolic disease was 1.80 (95% CI, 1.17–2.77). Conclusions Cardio‐metabolic disease was a common condition among hospitalized patients with COVID‐19, and it was associated with higher risks of in‐hospital mortality.

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Background: Previous studies showed that diabetes was a common comorbidity of COVID-19, but the effects of diabetes or anti-diabetic drugs on the mortality of COVID-19 have not been well described. To investigate the outcome of different status (with or without comorbidity) and anti-diabetic medication before admission of diabetic patients after SARS-CoV-2 infected, we collected clinical data of COVID-19 patients from Hubei Province and compared between diabetes and non-diabetes.Methods: In this multicenter and retrospective study, we enrolled 1,422 cases of consecutive hospitalized patients from January 21, 2020 to March 25, 2020 at six hospitals in Hubei Province, China. The primary endpoint was in-hospital mortality.Results: Diabetes patients were 10-years older than non-diabetes (p<0.001), had higher prevalence of comorbidities such as hypertension (p<0.001), coronary heart disease (p<0.001), cerebrovascular disease (CVD) (p<0.001), chronic kidney disease (CKD) (p=0.007). The incidence of mortality (p=0.003) were more prevalent among the diabetes group. Further analysis revealed that diabetes patients who took alpha-glucosidase inhibitor (AGI) had lower mortality rate(p<0.01). Multivariable Cox regression showed that male sex, hypertension, CKD, CVD, age were risk factors for the mortality of COVID-19. Survival curve revealed that, compared with diabetes only group, the mortality was increased in diabetes with comorbidities (p=0.009), but had no significant difference in the non-comorbidity group, p=0.59).Conclusions: Patients with diabetes had worse outcome when suffered with COVID-19, however, it was not associated with diabetes itself but the comorbidities. Furthermore, the administration of AGI could reduce the risk of death in patients with diabetes.

BackgroundPrevious studies have shown that diabetes mellitus is a common comorbidity of Coronavirus Disease 2019 (COVID-19), but the effects of diabetes or antidiabetic medication on the mortality of COVID-19 have not been well described. To investigate the outcome of different statuses (with or without comorbidity) and antidiabetic medication use before admission of patients with diabetes after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, we collected clinical data of patients with COVID-19 and compared those with diabetes versus nondiabetics.MethodsIn this multicenter and retrospective study, we enrolled 1,422 consecutive hospitalized patients from January 21 to March 25, 2020, at six hospitals in Hubei Province, China. The primary endpoint was in-hospital mortality.ResultsPatients with diabetes were 10 years older than nondiabetic patients (p<0.001) and had a higher prevalence of comorbidities such as hypertension (p<0.001), coronary heart disease (CHD) (p<0.001), cerebrovascular disease (CVD) (p<0.001), and chronic kidney disease (CKD) (p=0.007). Mortality (p=0.003) was more prevalent among the diabetes group. Further analysis revealed that patients with diabetes who took acarbose had a lower mortality rate (p<0.01). Multivariable Cox regression showed that male sex (hazard ratio [HR] 2.59 [1.68-3.99]), hypertension (HR 1.75 [1.18-2.60]), CKD (HR 4.55 [2.52-8.20]), CVD (HR 2.35 [1.27-4.33]), and age were risk factors for the COVID-19 mortality. Higher HRs were noted in those aged ≥65 (HR 11.8 [4.6- 30.2]) versus 50-64 years (HR 5.86 [2.27-15.12]). The survival curve revealed that, compared with the diabetes only group, the mortality was increased in the diabetes with comorbidities group (p=0.009) but had was not significantly different from the noncomorbidity group (p=0.59).ConclusionPatients with diabetes had worse outcomes when suffering from COVID-19; however, the outcome was not associated with diabetes itself but with comorbidities. Furthermore, the administration of acarbose could reduce the risk of death in patients with diabetes.