Clinical Characteristics and Outcomes of Patients With Diabetes and COVID-19 in Association With Glucose-Lowering Medication

Chen, Yu‐Chen; Yang, Dong; Cheng, Biao; Chen, Jian; Peng, Anlin; Yang, Chen; Liu, Chong; Xiong, Mingrui; Deng, Aiping; Zhang, Yu; Zheng, Ling; Huang, Kun

doi:10.2337/dc20-0660

Cited by 353 publications

(263 citation statements)

References 26 publications

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“…These results suggest that mechanisms through which type 2 diabetes and cardiovascular disease increase vulnerability to Covid-19 may overlap and are not additive. Although we did not investigate for the impact of cardiovascular disease on Covid-19 progression among inpatients, our data are in line with other studies which did not find independent associations between prior history of cardiovascular events and outcomes among patients with diabetes hospitalized for Covid-19 [18][19][20]. This topic needs, however further investigations, being still debated as contrasting data are reported depending on the chosen outcome [20].…”

Section: Discussionsupporting

confidence: 66%

“…According to the prespecified enrolment plan and matching strategy (Supplementary material), 158 controls matched for age and sex with the 79 Covid-19 cases were enrolled. When this analysis was carried out, 9 out of the 79 cases (11.4%) died 20 [12][13][14][15][16][17][18][19][20][21][22][23][24] days after hospitalization, 38 (48.1%) were discharged after 23 [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] males, p = 0.92) and body mass index. Cases were less likely ever smokers than controls (22.8% vs 45.6%, p = 0.001.…”

Section: Resultsmentioning

confidence: 99%

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Clinical features of patients with type 2 diabetes with and without Covid-19: A case control study (CoViDiab I)

Maddaloni

D’Onofrio

Alessandri

et al. 2020

Diabetes Research and Clinical Practice

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Aims To evaluate whether subjects with diabetes hospitalized for Coronavirus disease-19 (Covid-19) represent a subgroup of patients with high-risk clinical features compared to patients with diabetes without Covid-19. Methods In this case-control study 79 patients with type 2 diabetes out of 354 adults hospitalized for Covid-19 and 158 controls with type 2 diabetes but without Covid-19, matched for age and gender, were enrolled. Medical history and concomitant therapies were retrieved from medical charts and compared between cases and controls, controlling for confounders. Results Fully-adjusted multivariate logistic regression model showed that previous CVD history did not differ between patients with and without Covid-19 (odds ratio 1.40, 95% confidence interval [CI]: 0.59-3.32, p=0.45). A higher prevalence of chronic obstructive pulmonary disease (COPD) (OR 3.72, 95%CI: 1.42-9.72, p=0.007) and of chronic kidney disease (CKD) (OR 3.08, 95%CI: 1.18-8.06, p=0.022) and a lower prevalence of ever smokers (OR 0.30, 95%CI: 0.13-0.67, p=0.003), of users of lipid lowering agents (OR 0.26, 95%CI: 0.12-0.54, p<0.001), and of anti-hypertensive drugs (OR 0.39, 95%CI: 0.16-0.93, p=0.033) were found among cases. Conclusions CVD prevalence does not differ between people with diabetes with and without Covid-19 requiring hospitalization. An increased prevalence of COPD and of CKD in Covid-19 patients with type 2 diabetes is suggested. These findings aid to clarify the relationship between underlying conditions and SARS-CoV-2 infection in the high-risk group of patients with diabetes.

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Section: Discussionsupporting

confidence: 66%

Section: Resultsmentioning

confidence: 99%

Clinical features of patients with type 2 diabetes with and without Covid-19: A case control study (CoViDiab I)

Maddaloni

D’Onofrio

Alessandri

et al. 2020

Diabetes Research and Clinical Practice

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“…As for diabetes, previous studies have shown that diabetes can affect the prognosis of patients with viral pneumonia and it should, therefore, be analyzed separately from other comorbid diseases (15). In the univariate analysis performed here and in a previous study by Chen et al (17), diabetes was found to be associated with poor COVID-19 outcome. For this reason, we analyzed data from the diabetes patients separately from those with other comorbid diseases.…”

Section: Discussionmentioning

confidence: 50%

Clinical Characteristics and Prognosis of 218 Patients With COVID-19: A Retrospective Study Based on Clinical Classification

et al. 2020

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Background: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that has spread worldwide. Methods: This was a retrospective case series involving 218 patients admitted to three tertiary hospitals in the Loudi, Shaoyang, and Xiangtan areas of China from January 21 to June 27, 2020, who were confirmed by RT-PCR to have SARS-CoV-2. The patients' clinical characteristics, laboratory results, treatments, and prognoses based on clinical classification were recorded. Poor outcome was defined as admission to an ICU, the use of mechanical ventilation, or death. Results: The patients were classified into four clinical groups based on disease severity, namely mild (10/218, 5%), moderate (146/218, 67%), severe (24/218, 11%), or critical (14/218, 6%); 24 (11%) asymptomatic cases were also included in the study. The most common symptoms were self-reported cough (162/218, 74%), fever (145/218, 67%), sputum production (99/218, 45%), and fatigue (77/218, 35%). Among the 218 patients, 192 (88%) received lopinavir/ritonavir and interferon-alpha inhalation, and 196 (90%) patients received traditional Chinese medicine. Among the severe and critical patients, 25 (11%) were admitted to an ICU with or without mechanical ventilation, and one patient died. The presence of diabetes [relative risk (RR), 3.0; 95% CI, 1.3-6.8; p = 0.007) or other comorbidities (RR, 5.9; 95% CI, 1.9-17.8; p = 0.002) was independently associated with poor outcome. To date, 20 (9%) patients have retested positive for SARS-CoV-2 RNA after recovering and being discharged. Conclusion: The majority of patients in this case series were clinically classified as having moderate COVID-19. Older patients tended to present with greater levels of clinical severity. The prognosis for patients who were elderly or had diabetes or other chronic comorbidities was relatively poor.

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“…An association between diabetes, glycemic control and COVID-19 outcomes has been previously suggested in several studies, mostly coming from China [15,16]. It is important to note, however, that clinical features of patients reported in previous studies were different from ours on several aspects and that adjustment for confounding variables was heterogeneous [8,17]. Finally, different endpoints were considered, going from radiographic findings to ICU admission to in-hospital mortality [7].…”

Section: Discussionmentioning

confidence: 77%

Impact of diabetes on COVID-19-related in-hospital mortality: a retrospective study from Northern Italy

Ciardullo

Zerbini

Perra

et al. 2020

J Endocrinol Invest

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Purpose The purpose of this study was to evaluate the impact of pre-existing diabetes on in-hospital mortality in patients admitted for Coronavirus Disease 2019 (COVID-19). Methods This is a single center, retrospective study conducted at Policlinico di Monza hospital, located in the Lombardy region, Northern Italy. We reviewed medical records of 373 consecutive adult patients who were hospitalized with COVID-19 between February 22 and May 15, 2020. Data were collected on diabetes status, comorbid conditions and laboratory findings. Multivariable logistic regression was performed to evaluate the effect of diabetes on in-hospital mortality after adjustment for potential confounding variables. Results Mean age of the patients was 72 ± 14 years (range 17-98), 244 (65.4%) were male and 69 (18.5%) had diabetes. The most common comorbid conditions were hypertension (237 [64.8%]), cardiovascular disease (140 [37.7%]) and malignant neoplasms (50 [13.6%]). In-hospital death occurred in 142 (38.0%) patients. In the multivariable model older age (Relative Risk [RR] 1.06 [1.04-1. 09] per year), diabetes (RR 1.56 [1.05-2.02]), chronic obstructive pulmonary disease (RR 1.82 [1.13-2.35]), higher values of lactic dehydrogenase and C-reactive protein were independently associated with in-hospital mortality. Conclusion In this retrospective single-center study, diabetes was independently associated with a higher in-hospital mortality. More intensive surveillance of patients with this condition is to be warranted.

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Clinical Characteristics and Outcomes of Patients With Diabetes and COVID-19 in Association With Glucose-Lowering Medication

Cited by 353 publications

References 26 publications

Clinical features of patients with type 2 diabetes with and without Covid-19: A case control study (CoViDiab I)

Clinical features of patients with type 2 diabetes with and without Covid-19: A case control study (CoViDiab I)

Clinical Characteristics and Prognosis of 218 Patients With COVID-19: A Retrospective Study Based on Clinical Classification

Impact of diabetes on COVID-19-related in-hospital mortality: a retrospective study from Northern Italy

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