Phenotypic characteristics and prognosis of newly diagnosed diabetes in hospitalized patients with COVID-19: Results from the CORONADO study

Cariou, Bertrand; Pichelin, Matthieu; Goronflot, Thomas; Gonfroy, Céline; Marre, Michel; Raffaitin‐Cardin, Christelle; Thivolet, Charles; Wargny, Matthieu; Hadjadj, Samy; Gourdy, Pierre

doi:10.1016/j.diabres.2021.108695

Cited by 26 publications

(34 citation statements)

References 17 publications

(22 reference statements)

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“…7 The Coronavirus SARS-CoV-2 and Diabetes Outcomes (CORONADO) study in France found that in hospitalized patients with diabetes and COVID-19, sleep apnea was associated with increased risk of early death. 20…”

Section: Discussionmentioning

confidence: 99%

Severity of Sleep Apnea and COVID‐19 Illness

Kravitz

Yakubova

et al. 2021

OTO Open

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Objective To characterize the relationship between severity of sleep apnea and coronavirus disease 2019 (COVID-19) hospitalization and severe illness. Study Design Retrospective cohort study. Setting Montefiore Health System in the Bronx, New York. Methods The data set consisted of adult patients with an active diagnosis of obstructive sleep apnea in the past 2 years and a positive severe acute respiratory syndrome coronavirus 2 quantitative polymerase chain reaction test at our institution between March 16, 2020, and May 26, 2020. Sleep apnea severity and continuous positive airway pressure compliance data were abstracted from the electronic medical record. The International Classification of Diseases, 10th Revision was used to classify comorbidities. Results A total of 461 patients with sleep apnea tested positive for COVID-19, of whom 149 were excluded for missing data in the electronic medical record. Patients with moderate and severe sleep apnea had higher rates of COVID-19 hospitalization compared to those with mild sleep apnea ( P = .003). This association was reduced when accounting for confounders, most notably the Charlson Comorbidity Index, a measure of comorbid illness burden. Moderate and severe sleep apnea were associated with increased Charlson Comorbidity Indices, compared to mild sleep apnea ( P = .01). Sleep apnea severity was not associated with a composite outcome of mechanical ventilation, intensive care unit admission, and death. Conclusion Sleep apnea severity was associated with the Charlson Comorbidity Index and may be a risk factor for COVID-19 hospitalization. We found no evidence that sleep apnea severity among hospitalized patients was associated with a composite outcome of mechanical ventilation, intensive care unit admission, and death.

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Section: Discussionmentioning

confidence: 99%

Severity of Sleep Apnea and COVID‐19 Illness

Kravitz

Yakubova

et al. 2021

OTO Open

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“…Metformin use tended to be associated with a reduce risk of both COVID-19 severity and death. Of note, diabetes duration, smoking, hypertension, and concurrent cancer were not associated with COVID-19 severity or death among those hospitalized for COVID-19 (36,37) Figure 3 exemplifies the magnitude of risk associated with significant risk factors for deaths in adults with type 2 diabetes. Age and prevalent chronic kidney disease and CVD (coronary heart disease, stroke, heart failure) have the most glaring increase in absolute risk, ranging from 0.9% to 1.5% of the population over only 72 days (18).…”

Section: Predictors Of Covid-19-related Morbidity and Mortality Among Case Series With Diabetesmentioning

confidence: 96%

“…A comprehensive systematic review of 22 studies of the predictors of COVID-19 severity and death found male sex, age, several comorbid conditions (CVD, cerebrovascular disease, chronic kidney disease, chronic obstructive pulmonary disease), insulin use, and several laboratory predictors on admission, including elevated glucose levels, white blood cell count, neutrophil count, and lymphocyte count to all be significant (18,19,(35)(36)(37). Being overweight or obese was associated with 30% increased risk of severe COVID outcomes but was not associated with mortality.…”

Section: Predictors Of Covid-19-related Morbidity and Mortality Among Case Series With Diabetesmentioning

confidence: 99%

Diabetes and COVID-19: Population Impact 18 Months Into the Pandemic

2021

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Eighteen months into the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019 ) pandemic, epidemiologic studies indicate that diabetes is a central contributor to severe COVID-19 morbidity, and, conversely, COVID-19 has had a devastating effect on the population with diabetes. In this literature synthesis, we summarize the relationship of diabetes to COVID-19-related morbidity and mortality, discuss the predictors of severe adverse outcomes and implications of the overall pandemic, and critique the current status of and identify needs for epidemiologic studies for the next phase of the pandemic. Case series show that 30-40% of people with COVID-19-related hospitalization, severe morbidity requiring intensive care, and/or death have type 2 or type 1 diabetes. Among hospitalized individuals with diabetes, 21-43% required intensive care and case fatality is 25%. Risk of severe morbidity and mortality is 100-250% higher among people with diabetes than those without, even after adjustment for sociodemographic factors and comorbid conditions. Impact on the general population with diabetes has been similarly dire, as overall mortality rates were 50% higher than historical trends, a net increase more than twice that of the general population. Of the excess deaths, 75-80% are not officially attributed to COVID-19, which raises unanswered questions about missed attribution or collateral impact. Many predictors of poor outcomes have been identified, particularly comorbid conditions (chronic kidney disease, coronary heart disease, and heart failure), concurrent obesity, and acute and chronic poor HbA 1c control, that point to the potential to reduce severe morbidity and mortality in its next stages. However, response to the continuing pandemic will benefit from population-wide studies with broader examination of the risks of exposure, infection, and hospitalization, for which few data currently exist. The indirect impact of the pandemic's effects on health services, health behaviors, disease management, care, control, and complications has not been well quantified; determining this impact will be essential to lessen the future impact. Expanding epidemiologic studies of the relationship of diabetes to COVID-19 beyond few high-income countries will also be essential to limit the burden in low-and middle-income countries where 80% of individuals with diabetes reside and where the COVID-19 pandemic has been so damaging.Barely 1 month following the first reported severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019 ) clusters, diabetes was already identified as an associated factor and key predictor of poor outcomes (1,2). As case series expanded beyond China and were gradually complemented by larger cohorts, the evidence for a central role of diabetes in the COVID-19 epidemic only strengthened, and numerous etiologic links were identified. The potential pathways, including disruption of glucose metabolism, immune

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“…Many studies have recently reported that COVID-associated hyperglycaemia is associated with a poorer outcome compared to that of the normoglycaemic individuals [ 31 , 32 , 33 , 34 , 35 , 36 ]. However, whether COVID-associated hyperglycaemia is associated with a poorer clinical outcome compared to pre-existing diabetes is still an open question, and there have been conflicting findings [ 32 , 34 , 37 , 38 , 39 ]. Moreover, data on islet autoimmunity prevalence, anti-SARS-CoV-2 antibody responses, and timing for viral clearance are still missing.…”

Section: Introductionmentioning

confidence: 99%

Pre-Existing Diabetes and COVID-Associated Hyperglycaemia in Patients with COVID-19 Pneumonia

Laurenzi

Caretto

Molinari

et al. 2021

Biology

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Aim. The aim of the current study was to compare clinical characteristics, laboratory findings, and major outcomes of patients hospitalized for COVID-19 pneumonia with COVID-associated hyperglycaemia or pre-existing diabetes. Methods. A cohort of 176 adult patients with a diagnosis of pre-existing diabetes (n = 112) or COVID-associated hyperglycaemia (n = 55) was studied. Results. Patients with COVID-associated hyperglycaemia had lower BMI, significantly less comorbidities, and higher levels of inflammatory markers and indicators of multi-organ injury than those with pre-existing diabetes. No differences between pre-existing diabetes and COVID-associated hyperglycaemia were evident for symptoms at admission, the humoral response against SARS-CoV-2, or autoantibodies to glutamic acid decarboxylase or interferon alpha-4. COVID-associated hyperglycaemia was independently associated with the risk of adverse clinical outcome, which was defined as ICU admission or death (HR 2.11, 95% CI 1.34–3.31; p = 0.001), even after adjustment for age, sex, and other selected variables associated with COVID-19 severity. Furthermore, at the same time, we documented a negative association (HR 0.661, 95% CI 0.43–1.02; p = 0.063) between COVID-associated hyperglycaemia to swab negativization. Conclusions. Recognizing hyperglycaemia as a specific clinical entity associated with COVID-19 pneumonia is relevant for early and appropriate patient management and close monitoring for the progression of disease severity.

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Phenotypic characteristics and prognosis of newly diagnosed diabetes in hospitalized patients with COVID-19: Results from the CORONADO study

Cited by 26 publications

References 17 publications

Severity of Sleep Apnea and COVID‐19 Illness

Severity of Sleep Apnea and COVID‐19 Illness

Diabetes and COVID-19: Population Impact 18 Months Into the Pandemic

Pre-Existing Diabetes and COVID-Associated Hyperglycaemia in Patients with COVID-19 Pneumonia

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