COVID‐19 fatality prediction in people with diabetes and prediabetes using a simple score upon hospital admission

Abstract

Aim To assess predictors of in‐hospital mortality in people with prediabetes and diabetes hospitalized for COVID‐19 infection and to develop a risk score for identifying those at the greatest risk of a fatal outcome. Materials and Methods A combined prospective and retrospective, multicentre, cohort study was conducted at 10 sites in Austria in 247 people with diabetes or newly diagnosed prediabetes who were hospitalized with COVID‐19. The primary outcome was in‐hospital mortality and the predictor variables upon admission included clinical data, co‐morbidities of diabetes or laboratory data. Logistic regression analyses were performed to identify significant predictors and to develop a risk score for in‐hospital mortality. Results The mean age of people hospitalized (n = 238) for COVID‐19 was 71.1 ± 12.9 years, 63.6% were males, 75.6% had type 2 diabetes, 4.6% had type 1 diabetes and 19.8% had prediabetes. The mean duration of hospital stay was 18 ± 16 days, 23.9% required ventilation therapy and 24.4% died in the hospital. The mortality rate in people with diabetes was numerically higher (26.7%) compared with those with prediabetes (14.9%) but without statistical significance ( P = .128). A score including age, arterial occlusive disease, C‐reactive protein, estimated glomerular filtration rate and aspartate aminotransferase levels at admission predicted in‐hospital mortality with a C‐statistic of 0.889 (95% CI: 0.837‐0.941) and calibration of 1.000 ( P = .909). Conclusions The in‐hospital mortality for COVID‐19 was high in people with diabetes but not significantly different to the risk in people with prediabetes. A risk score using five routinely available patient variables showed excellent predictive performance for assessing in‐hospital mortality.

Diabetes predicts severity of COVID‐19 infection in a retrospective cohort: A mediatory role of the inflammatory biomarker C‐reactive protein

“…This supports the findings from a recent study. 36 Even though primary outcome event numbers were small in this group to draw a definitive conclusion, there was no trend towards poorer outcomes, even with baseline CRP level. A graded increase in some biomarkers of inflammation such as white cell count and fibrinogen was reported from normoglycemia to prediabetes to diabetes, while other markers such as neopterin, albumin, and hematocrit showed no such changes in prediabetes.…”

Dipeptidyl peptidase 4 (DPP4) inhibitor and outcome from coronavirus disease 2019 (COVID-19) in diabetic patients: a systematic review, meta-analysis, and meta-regression

“…A total of 4592 records were excluded after screening the titles/abstracts because they did not match our inclusion and exclusion criteria. After evaluating 22 full-texts for eligibility, 7 full-text articles were excluded because they do not have the outcome of interest (severe COVID-19 or mortality), 3 full-text articles were excluded because they do not have the control/comparison group, 2 articles were excluded because the full text not in English, and finally, 10 studies [16][17][18][19][20][21][22][23][24][25] with a total of 7012 COVID-19 patients with diabetes were included in the meta-analysis (Fig. 1).…”

Metformin therapy and severity and mortality of SARS-CoV-2 infection: a meta-analysis

“…Out of 946 potentially relevant articles, and following application of inclusion criteria, 32 studies were retained including a total of 44306 participants. The included studies were conducted in Austria [14], Belgium [15], China [16][17][18][19][20][21][22][23][24], France [25][26][27], Hong Kong [28], Iraq [29], Italy [30,31], Russia [32]which determines the high relevance of risk factor analysis for outcomes in DM patients to substantiate the strategy for this category of patients. AIM: To assess the effect of clinical and demographic parameters (age, gender, body mass index (BMI, South Korea [33,34], Spain [35,36], UK [37][38][39][40][41] and USA [42][43][44][45].…”