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Predictors of mortality in critically ill patients with COVID-19 and diabetes
The COVID-19 pandemic has challenged the entire world, and patients with diabetes mellitus (DM) have been particularly affected. We aimed to evaluate predictors of mortality during the first 30 days of hospitalization in critically ill patients with COVID-19 and comorbid DM. This prospective study i...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Associação Brasileira de Divulgação Científica
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10427161/ https://www.ncbi.nlm.nih.gov/pubmed/37585916 http://dx.doi.org/10.1590/1414-431X2023e12728 |
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author | Lázaro, A.P.P. Zaranza, M.S. Meneses, G.C. Aragão, N.L. Freire, M.V.P. Guimarães, Á.R. Beliero, A.M. Dantas, M.M.P. Forte, L.C. Martins, A.M.C. Daher, E.F. Albuquerque, P.L.M.M. da Silva, G.B. |
author_facet | Lázaro, A.P.P. Zaranza, M.S. Meneses, G.C. Aragão, N.L. Freire, M.V.P. Guimarães, Á.R. Beliero, A.M. Dantas, M.M.P. Forte, L.C. Martins, A.M.C. Daher, E.F. Albuquerque, P.L.M.M. da Silva, G.B. |
author_sort | Lázaro, A.P.P. |
collection | PubMed |
description | The COVID-19 pandemic has challenged the entire world, and patients with diabetes mellitus (DM) have been particularly affected. We aimed to evaluate predictors of mortality during the first 30 days of hospitalization in critically ill patients with COVID-19 and comorbid DM. This prospective study included 110 critically ill patients admitted with COVID-19 infection. Thirty-two (29%) patients had a previous diagnosis of DM. Clinical variables, laboratory tests, and vascular biomarkers, such as VCAM-1, syndecan-1, ICAM-1, angiopoietin-1, and angiopoeitin-2, were evaluated after intensive care unit (ICU) admission. A comparison was made between patients with and without DM. No difference in mortality was observed between the groups (48.7 vs 46.9%, P=0.861). In the multivariate Cox regression analysis, VCAM-1 levels at ICU admission (HR: 1 [1-1.001], P<0.006) were associated with death in patients with DM. Among patients with DM, advanced age (HR 1.063 [1.031-1.096], P<0.001), increased Ang-2/Ang-1 ratio (HR: 4.515 [1.803-11.308] P=0.001), and need for dialysis (HR: 3.489 [1.409-8.642], P=0.007) were independent predictors of death. Higher levels of VCAM-1 in patients with DM was better at predicting death of patients with severe COVID-19 and comorbid DM, and their cut-off values were useful for stratifying patients with a worse prognosis. Vascular biomarkers VCAM-1 and Ang-2/Ang-1 ratio were predictors of death in patients with severe COVID-19 and comorbid DM and those without DM. Additionally, kidney injury was associated with an increased risk of death. |
format | Online Article Text |
id | pubmed-10427161 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Associação Brasileira de Divulgação Científica |
record_format | MEDLINE/PubMed |
spelling | pubmed-104271612023-08-16 Predictors of mortality in critically ill patients with COVID-19 and diabetes Lázaro, A.P.P. Zaranza, M.S. Meneses, G.C. Aragão, N.L. Freire, M.V.P. Guimarães, Á.R. Beliero, A.M. Dantas, M.M.P. Forte, L.C. Martins, A.M.C. Daher, E.F. Albuquerque, P.L.M.M. da Silva, G.B. Braz J Med Biol Res Research Article The COVID-19 pandemic has challenged the entire world, and patients with diabetes mellitus (DM) have been particularly affected. We aimed to evaluate predictors of mortality during the first 30 days of hospitalization in critically ill patients with COVID-19 and comorbid DM. This prospective study included 110 critically ill patients admitted with COVID-19 infection. Thirty-two (29%) patients had a previous diagnosis of DM. Clinical variables, laboratory tests, and vascular biomarkers, such as VCAM-1, syndecan-1, ICAM-1, angiopoietin-1, and angiopoeitin-2, were evaluated after intensive care unit (ICU) admission. A comparison was made between patients with and without DM. No difference in mortality was observed between the groups (48.7 vs 46.9%, P=0.861). In the multivariate Cox regression analysis, VCAM-1 levels at ICU admission (HR: 1 [1-1.001], P<0.006) were associated with death in patients with DM. Among patients with DM, advanced age (HR 1.063 [1.031-1.096], P<0.001), increased Ang-2/Ang-1 ratio (HR: 4.515 [1.803-11.308] P=0.001), and need for dialysis (HR: 3.489 [1.409-8.642], P=0.007) were independent predictors of death. Higher levels of VCAM-1 in patients with DM was better at predicting death of patients with severe COVID-19 and comorbid DM, and their cut-off values were useful for stratifying patients with a worse prognosis. Vascular biomarkers VCAM-1 and Ang-2/Ang-1 ratio were predictors of death in patients with severe COVID-19 and comorbid DM and those without DM. Additionally, kidney injury was associated with an increased risk of death. Associação Brasileira de Divulgação Científica 2023-08-14 /pmc/articles/PMC10427161/ /pubmed/37585916 http://dx.doi.org/10.1590/1414-431X2023e12728 Text en https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Lázaro, A.P.P. Zaranza, M.S. Meneses, G.C. Aragão, N.L. Freire, M.V.P. Guimarães, Á.R. Beliero, A.M. Dantas, M.M.P. Forte, L.C. Martins, A.M.C. Daher, E.F. Albuquerque, P.L.M.M. da Silva, G.B. Predictors of mortality in critically ill patients with COVID-19 and diabetes |
title | Predictors of mortality in critically ill patients with COVID-19 and diabetes |
title_full | Predictors of mortality in critically ill patients with COVID-19 and diabetes |
title_fullStr | Predictors of mortality in critically ill patients with COVID-19 and diabetes |
title_full_unstemmed | Predictors of mortality in critically ill patients with COVID-19 and diabetes |
title_short | Predictors of mortality in critically ill patients with COVID-19 and diabetes |
title_sort | predictors of mortality in critically ill patients with covid-19 and diabetes |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10427161/ https://www.ncbi.nlm.nih.gov/pubmed/37585916 http://dx.doi.org/10.1590/1414-431X2023e12728 |
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