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

Maddaloni, Ernesto; D’Onofrio, Luca; Alessandri, Francesco; Mignogna, Carmen; Leto, Gaetano; Coraggio, Lucia; Sterpetti, Sara; Porcellini, Giuseppe; Mezzaroma, Ivano; Lichtner, Miriam; Pozzilli, Paolo; Agrò, Felice Eugenio; Rocco, Monica; Pugliese, Francesco; Mastroianni, Claudio Maria; Buzzetti, Raffaella

doi:10.1016/j.diabres.2020.108454

Cited by 36 publications

(39 citation statements)

References 34 publications

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“…The Covid-19 & Diabetes (CoViDiab) study is a multicenter observational study which collected data retrospectively from medical charts of patients hospitalized for Covid-19 from March 1 st to May 15 th , 2020 in four academic hospitals located in the Lazio region of Italy: Umberto I "Policlinico" General hospital and Sant' Andrea hospital, Sapienza University of Rome; Santa Maria Goretti hospital, Polo Pontino of Sapienza University in Latina; Campus Bio-Medico University hospital in Rome [23]. Patients eligible for inclusion were aged ≥ 18 years old with a diagnosis of Covid-19 confirmed by at least one real-time polymerase chain reaction assay, in accordance with the protocol established by the World Health Organisation [24].…”

Section: Study Design and Populationmentioning

confidence: 99%

Cardiometabolic multimorbidity is associated with a worse Covid-19 prognosis than individual cardiometabolic risk factors: a multicentre retrospective study (CoViDiab II)

Lenzi

Holman

Ajassa³

et al. 2020

Cardiovasc Diabetol

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101

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Background Cardiometabolic disorders may worsen Covid-19 outcomes. We investigated features and Covid-19 outcomes for patients with or without diabetes, and with or without cardiometabolic multimorbidity. Methods We collected and compared data retrospectively from patients hospitalized for Covid-19 with and without diabetes, and with and without cardiometabolic multimorbidity (defined as ≥ two of three risk factors of diabetes, hypertension or dyslipidaemia). Multivariate logistic regression was used to assess the risk of the primary composite outcome (any of mechanical ventilation, admission to an intensive care unit [ICU] or death) in patients with diabetes and in those with cardiometabolic multimorbidity, adjusting for confounders. Results Of 354 patients enrolled, those with diabetes (n = 81), compared with those without diabetes (n = 273), had characteristics associated with the primary composite outcome that included older age, higher prevalence of hypertension and chronic obstructive pulmonary disease (COPD), higher levels of inflammatory markers and a lower PaO2/FIO2 ratio. The risk of the primary composite outcome in the 277 patients who completed the study as of May 15th, 2020, was higher in those with diabetes (Adjusted Odds Ratio (adjOR) 2.04, 95%CI 1.12–3.73, p = 0.020), hypertension (adjOR 2.31, 95%CI: 1.37–3.92, p = 0.002) and COPD (adjOR 2.67, 95%CI 1.23–5.80, p = 0.013). Patients with cardiometabolic multimorbidity were at higher risk compared to patients with no cardiometabolic conditions (adjOR 3.19 95%CI 1.61–6.34, p = 0.001). The risk for patients with a single cardiometabolic risk factor did not differ with that for patients with no cardiometabolic risk factors (adjOR 1.66, 0.90–3.06, adjp = 0.10). Conclusions Patients with diabetes hospitalized for Covid-19 present with high-risk features. They are at increased risk of adverse outcomes, likely because diabetes clusters with other cardiometabolic conditions.

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Section: Study Design and Populationmentioning

confidence: 99%

Cardiometabolic multimorbidity is associated with a worse Covid-19 prognosis than individual cardiometabolic risk factors: a multicentre retrospective study (CoViDiab II)

Lenzi

Holman

Ajassa³

et al. 2020

Cardiovasc Diabetol

Self Cite

101

View full text Add to dashboard Cite

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“…Significantly, Maddaloni et al suggested an increased prevalence of COPD and of chronic kidney disease (CKD) in Covid-19 patients with diabetes (6).…”

Section: Worse Outcomes In Covid-19 Patients Affected By Obesity and mentioning

confidence: 99%

Impact of Diabetes in Patients Diagnosed With COVID-19

et al. 2020

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COVID-19 is a disease caused by the coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2), known as a highly contagious disease, currently affecting more than 200 countries worldwide. The main feature of SARS-CoV-2 that distinguishes it from other viruses is the speed of transmission combined with higher risk of mortality from acute respiratory distress syndrome (ARDS). People with diabetes mellitus (DM), severe obesity, cardiovascular disease, and hypertension are more likely to get infected and are at a higher risk of mortality from COVID-19. Among elderly patients who are at higher risk of death from COVID-19, 26.8% have DM. Although the reasons for this increased risk are yet to be determined, several factors may contribute to type-2 DM patients’ increased susceptibility to infections. A possible factor that may play a role in increasing the risk in people affected by diabetes and/or obesity is the impaired innate and adaptive immune response, characterized by a state of chronic and low-grade inflammation that can lead to abrupt systemic metabolic alteration. SARS patients previously diagnosed with diabetes or hyperglycemia had higher mortality and morbidity rates when compared with patients who were under metabolic control. Similarly, obese individuals are at higher risk of developing complications from SARS-CoV-2. In this review, we will explore the current and evolving insights pertinent to the metabolic impact of coronavirus infections with special attention to the main pathways and mechanisms that are linked to the pathophysiology and treatment of diabetes.

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“…However, COPD did not remain independently associated with hospitalization risk. Conversely, the CoViDiab I and II studies showed that COPD was significantly associated with a higher risk of both COVID-19 hospitalization and progression towards bad outcomes [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…The epidemic of coronavirus disease 2019 (COVID- 19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), reported in Wuhan, China in December 2019, before rapidly spreading worldwide. Pandemic status was declared by the World Health Organization in March 2020 [1].…”

Section: Introductionmentioning

confidence: 99%

Phenotypic Characteristics and Development of a Hospitalization Prediction Risk Score for Outpatients with Diabetes and COVID-19: The DIABCOVID Study

Lasbleiz

Cariou

Darmon

et al. 2020

JCM

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Diabetes mellitus (DM) has been identified as a risk factor for severe COVID-19. DM is highly prevalent in the general population. Defining strategies to reduce the health care system burden and the late arrival of some patients thus seems crucial. The study aim was to compare phenotypic characteristics between in and outpatients with diabetes and infected by COVID-19, and to build an easy-to-use hospitalization prediction risk score. This was a retrospective observational study. Patients with DM and laboratory- or CT-confirmed COVID-19, who did (n = 185) and did not (n = 159) require hospitalization between 10 March and 10 April 2020, were compared. Data on diabetes duration, treatments, glycemic control, complications, anthropometrics and peripheral oxygen saturation (SpO2) were collected from medical records. Stepwise multivariate logistic regressions and ROC analyses were performed to build the DIAB score, a score using no more than five easy-to-collect clinical parameters predicting the risk of hospitalization. The DIAB score was then validated in two external cohorts (n = 132 and n = 2036). Hospitalized patients were older (68.0 ± 12.6 vs. 55.2 ± 12.6 years, p < 0.001), with more class III obesity (BMI ≥ 40 kg/m2, 9.7 vs. 3.5%, p = 0.03), hypertension (81.6 vs. 44.3%, p < 0.0001), insulin therapy (37% vs. 23.7%, p = 0.009), and lower SpO2 (91.6 vs. 97.3%, p < 0.0001) than outpatients. Type 2 DM (T2D) was found in 94% of all patients, with 10 times more type 1 DM in the outpatient group (11.3 vs. 1.1%, p < 0.0001). A DIAB score > 27 points predicted hospitalization (sensitivity 77.7%, specificity 89.2%, AUC = 0.895), and death within 28 days. Its performance was validated in the two external cohorts. Outpatients with diabetes were found to be younger, with fewer diabetic complications and less severe obesity than inpatients. DIAB score is an easy-to-use score integrating five variables to help clinicians better manage patients with DM and avert the saturation of emergency care units.

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

Cited by 36 publications

References 34 publications

Cardiometabolic multimorbidity is associated with a worse Covid-19 prognosis than individual cardiometabolic risk factors: a multicentre retrospective study (CoViDiab II)

Cardiometabolic multimorbidity is associated with a worse Covid-19 prognosis than individual cardiometabolic risk factors: a multicentre retrospective study (CoViDiab II)

Impact of Diabetes in Patients Diagnosed With COVID-19

Phenotypic Characteristics and Development of a Hospitalization Prediction Risk Score for Outpatients with Diabetes and COVID-19: The DIABCOVID Study

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