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Preadmission Diabetes-Specific Risk Factors for Mortality in Hospitalized Patients With Diabetes and Coronavirus Disease 2019

OBJECTIVE: To examine whether HbA(1c), outpatient diabetes treatment regimen, demographics, and clinical characteristics are associated with mortality in hospitalized patients with diabetes and coronavirus disease 2019 (COVID-19). RESEARCH DESIGN AND METHODS: This was a retrospective cohort analysis...

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Autores principales: Agarwal, Shivani, Schechter, Clyde, Southern, Will, Crandall, Jill P., Tomer, Yaron
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Diabetes Association 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7510015/
https://www.ncbi.nlm.nih.gov/pubmed/32769128
http://dx.doi.org/10.2337/dc20-1543
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author Agarwal, Shivani
Schechter, Clyde
Southern, Will
Crandall, Jill P.
Tomer, Yaron
author_facet Agarwal, Shivani
Schechter, Clyde
Southern, Will
Crandall, Jill P.
Tomer, Yaron
author_sort Agarwal, Shivani
collection PubMed
description OBJECTIVE: To examine whether HbA(1c), outpatient diabetes treatment regimen, demographics, and clinical characteristics are associated with mortality in hospitalized patients with diabetes and coronavirus disease 2019 (COVID-19). RESEARCH DESIGN AND METHODS: This was a retrospective cohort analysis of patients with diabetes hospitalized with confirmed COVID-19 infection from 11 March to 7 May 2020 at a large academic medical center in New York City. Multivariate modeling was used to assess the independent association of HbA(1c) levels and outpatient diabetes treatment regimen with mortality, in addition to independent effects of demographic and clinical characteristics. RESULTS: We included 1,126 hospitalized patients with diabetes and COVID-19 for analysis, among whom mean age was 68 years, 50% were male, 75% were Black, mean BMI was 30 kg/m(2), 98% had type 2 diabetes, mean HbA(1c) was 7.5%, and 33.1% died. HbA(1c) levels were not associated with mortality in unadjusted or adjusted analyses, but an outpatient regimen with any insulin treatment was strongly predictive. Additionally, age, sex, and BMI interacted such that in all age categories, mortality was higher with increasing BMI in males compared with females. CONCLUSIONS: In this large U.S. cohort of hospitalized patients with diabetes and COVID-19, insulin treatment, as a possible proxy for diabetes duration, and obesity rather than long-term glycemic control were predictive of mortality. Further investigation of underlying mechanisms of mortality and inpatient glycemic control is needed.
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spelling pubmed-75100152020-10-02 Preadmission Diabetes-Specific Risk Factors for Mortality in Hospitalized Patients With Diabetes and Coronavirus Disease 2019 Agarwal, Shivani Schechter, Clyde Southern, Will Crandall, Jill P. Tomer, Yaron Diabetes Care Diabetes and COVID-19—Growing Understanding of the Links OBJECTIVE: To examine whether HbA(1c), outpatient diabetes treatment regimen, demographics, and clinical characteristics are associated with mortality in hospitalized patients with diabetes and coronavirus disease 2019 (COVID-19). RESEARCH DESIGN AND METHODS: This was a retrospective cohort analysis of patients with diabetes hospitalized with confirmed COVID-19 infection from 11 March to 7 May 2020 at a large academic medical center in New York City. Multivariate modeling was used to assess the independent association of HbA(1c) levels and outpatient diabetes treatment regimen with mortality, in addition to independent effects of demographic and clinical characteristics. RESULTS: We included 1,126 hospitalized patients with diabetes and COVID-19 for analysis, among whom mean age was 68 years, 50% were male, 75% were Black, mean BMI was 30 kg/m(2), 98% had type 2 diabetes, mean HbA(1c) was 7.5%, and 33.1% died. HbA(1c) levels were not associated with mortality in unadjusted or adjusted analyses, but an outpatient regimen with any insulin treatment was strongly predictive. Additionally, age, sex, and BMI interacted such that in all age categories, mortality was higher with increasing BMI in males compared with females. CONCLUSIONS: In this large U.S. cohort of hospitalized patients with diabetes and COVID-19, insulin treatment, as a possible proxy for diabetes duration, and obesity rather than long-term glycemic control were predictive of mortality. Further investigation of underlying mechanisms of mortality and inpatient glycemic control is needed. American Diabetes Association 2020-10 2020-08-07 /pmc/articles/PMC7510015/ /pubmed/32769128 http://dx.doi.org/10.2337/dc20-1543 Text en © 2020 by the American Diabetes Association https://www.diabetesjournals.org/content/licenseReaders may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at https://www.diabetesjournals.org/content/license.
spellingShingle Diabetes and COVID-19—Growing Understanding of the Links
Agarwal, Shivani
Schechter, Clyde
Southern, Will
Crandall, Jill P.
Tomer, Yaron
Preadmission Diabetes-Specific Risk Factors for Mortality in Hospitalized Patients With Diabetes and Coronavirus Disease 2019
title Preadmission Diabetes-Specific Risk Factors for Mortality in Hospitalized Patients With Diabetes and Coronavirus Disease 2019
title_full Preadmission Diabetes-Specific Risk Factors for Mortality in Hospitalized Patients With Diabetes and Coronavirus Disease 2019
title_fullStr Preadmission Diabetes-Specific Risk Factors for Mortality in Hospitalized Patients With Diabetes and Coronavirus Disease 2019
title_full_unstemmed Preadmission Diabetes-Specific Risk Factors for Mortality in Hospitalized Patients With Diabetes and Coronavirus Disease 2019
title_short Preadmission Diabetes-Specific Risk Factors for Mortality in Hospitalized Patients With Diabetes and Coronavirus Disease 2019
title_sort preadmission diabetes-specific risk factors for mortality in hospitalized patients with diabetes and coronavirus disease 2019
topic Diabetes and COVID-19—Growing Understanding of the Links
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7510015/
https://www.ncbi.nlm.nih.gov/pubmed/32769128
http://dx.doi.org/10.2337/dc20-1543
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