Cargando…

Characteristics, Management, and Outcomes of Elderly Patients with Diabetes in a Covid-19 Unit: Lessons Learned from a Pilot Study

Background and objectives: Diabetes may affect in-hospital mortality of patients with Coronavirus disease 2019 (COVID-19). We have retrospectively evaluated clinical characteristics, diabetes management, and outcomes in a sample of COVID-19 patients with diabetes admitted to our hospital. Materials...

Descripción completa

Detalles Bibliográficos
Autores principales: Ricchio, Marco, Tassone, Bruno, Pelle, Maria Chiara, Mazzitelli, Maria, Serapide, Francesca, Fusco, Paolo, Lionello, Rosaria, Cancelliere, Anna, Procopio, Giada, Lio, Elena, Trecarichi, Enrico Maria, Torti, Carlo, Irace, Concetta
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8065491/
https://www.ncbi.nlm.nih.gov/pubmed/33916210
http://dx.doi.org/10.3390/medicina57040341
_version_ 1783682353954029568
author Ricchio, Marco
Tassone, Bruno
Pelle, Maria Chiara
Mazzitelli, Maria
Serapide, Francesca
Fusco, Paolo
Lionello, Rosaria
Cancelliere, Anna
Procopio, Giada
Lio, Elena
Trecarichi, Enrico Maria
Torti, Carlo
Irace, Concetta
author_facet Ricchio, Marco
Tassone, Bruno
Pelle, Maria Chiara
Mazzitelli, Maria
Serapide, Francesca
Fusco, Paolo
Lionello, Rosaria
Cancelliere, Anna
Procopio, Giada
Lio, Elena
Trecarichi, Enrico Maria
Torti, Carlo
Irace, Concetta
author_sort Ricchio, Marco
collection PubMed
description Background and objectives: Diabetes may affect in-hospital mortality of patients with Coronavirus disease 2019 (COVID-19). We have retrospectively evaluated clinical characteristics, diabetes management, and outcomes in a sample of COVID-19 patients with diabetes admitted to our hospital. Materials and Methods: All patients admitted to the Infectious Diseases Unit from 28 March 2020, to 16 June 2020, were enrolled. Clinical information and biochemical parameters were collected at the time of admission. Patients were ranked according to diabetes and death. Results: Sixty-one patients with COVID-19 were analyzed. Most of them were from a long-term health care facility. Mean age was 77 ± 16 years, and 19 had type 2 diabetes (T2D). Eighteen patients died, including 8 with T2D and 10 without T2D (p = 0.15). Patients with diabetes were significantly older, had a higher prevalence of cardiovascular diseases, and a significantly lower lymphocyte count. No significant relationship was found between diabetes and in-hospital mortality (Odds Ratio OR 2.3; Confidence Interval CI 0.73–7.38, p = 0.15). Patients with diabetes were treated with insulin titration algorithm. Severe hypoglycemic events, ketoacidosis and hyperosmolar hyperglycemias did not occur during hospitalization. Mean pre-meal capillary blood glucose was 157 ± 45 mg/dL, and the coefficient of variation of glycaemia was 29%. Conclusions: Our study, albeit limited by the small number of subjects, did not describe any significant association between T2D diabetes and mortality. Clinical characteristics of patients, and acceptable glucose control prior and during hospitalization may have influenced the result. The use of an insulin titration algorithm should be pursued during hospitalization.
format Online
Article
Text
id pubmed-8065491
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-80654912021-04-25 Characteristics, Management, and Outcomes of Elderly Patients with Diabetes in a Covid-19 Unit: Lessons Learned from a Pilot Study Ricchio, Marco Tassone, Bruno Pelle, Maria Chiara Mazzitelli, Maria Serapide, Francesca Fusco, Paolo Lionello, Rosaria Cancelliere, Anna Procopio, Giada Lio, Elena Trecarichi, Enrico Maria Torti, Carlo Irace, Concetta Medicina (Kaunas) Article Background and objectives: Diabetes may affect in-hospital mortality of patients with Coronavirus disease 2019 (COVID-19). We have retrospectively evaluated clinical characteristics, diabetes management, and outcomes in a sample of COVID-19 patients with diabetes admitted to our hospital. Materials and Methods: All patients admitted to the Infectious Diseases Unit from 28 March 2020, to 16 June 2020, were enrolled. Clinical information and biochemical parameters were collected at the time of admission. Patients were ranked according to diabetes and death. Results: Sixty-one patients with COVID-19 were analyzed. Most of them were from a long-term health care facility. Mean age was 77 ± 16 years, and 19 had type 2 diabetes (T2D). Eighteen patients died, including 8 with T2D and 10 without T2D (p = 0.15). Patients with diabetes were significantly older, had a higher prevalence of cardiovascular diseases, and a significantly lower lymphocyte count. No significant relationship was found between diabetes and in-hospital mortality (Odds Ratio OR 2.3; Confidence Interval CI 0.73–7.38, p = 0.15). Patients with diabetes were treated with insulin titration algorithm. Severe hypoglycemic events, ketoacidosis and hyperosmolar hyperglycemias did not occur during hospitalization. Mean pre-meal capillary blood glucose was 157 ± 45 mg/dL, and the coefficient of variation of glycaemia was 29%. Conclusions: Our study, albeit limited by the small number of subjects, did not describe any significant association between T2D diabetes and mortality. Clinical characteristics of patients, and acceptable glucose control prior and during hospitalization may have influenced the result. The use of an insulin titration algorithm should be pursued during hospitalization. MDPI 2021-04-01 /pmc/articles/PMC8065491/ /pubmed/33916210 http://dx.doi.org/10.3390/medicina57040341 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ricchio, Marco
Tassone, Bruno
Pelle, Maria Chiara
Mazzitelli, Maria
Serapide, Francesca
Fusco, Paolo
Lionello, Rosaria
Cancelliere, Anna
Procopio, Giada
Lio, Elena
Trecarichi, Enrico Maria
Torti, Carlo
Irace, Concetta
Characteristics, Management, and Outcomes of Elderly Patients with Diabetes in a Covid-19 Unit: Lessons Learned from a Pilot Study
title Characteristics, Management, and Outcomes of Elderly Patients with Diabetes in a Covid-19 Unit: Lessons Learned from a Pilot Study
title_full Characteristics, Management, and Outcomes of Elderly Patients with Diabetes in a Covid-19 Unit: Lessons Learned from a Pilot Study
title_fullStr Characteristics, Management, and Outcomes of Elderly Patients with Diabetes in a Covid-19 Unit: Lessons Learned from a Pilot Study
title_full_unstemmed Characteristics, Management, and Outcomes of Elderly Patients with Diabetes in a Covid-19 Unit: Lessons Learned from a Pilot Study
title_short Characteristics, Management, and Outcomes of Elderly Patients with Diabetes in a Covid-19 Unit: Lessons Learned from a Pilot Study
title_sort characteristics, management, and outcomes of elderly patients with diabetes in a covid-19 unit: lessons learned from a pilot study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8065491/
https://www.ncbi.nlm.nih.gov/pubmed/33916210
http://dx.doi.org/10.3390/medicina57040341
work_keys_str_mv AT ricchiomarco characteristicsmanagementandoutcomesofelderlypatientswithdiabetesinacovid19unitlessonslearnedfromapilotstudy
AT tassonebruno characteristicsmanagementandoutcomesofelderlypatientswithdiabetesinacovid19unitlessonslearnedfromapilotstudy
AT pellemariachiara characteristicsmanagementandoutcomesofelderlypatientswithdiabetesinacovid19unitlessonslearnedfromapilotstudy
AT mazzitellimaria characteristicsmanagementandoutcomesofelderlypatientswithdiabetesinacovid19unitlessonslearnedfromapilotstudy
AT serapidefrancesca characteristicsmanagementandoutcomesofelderlypatientswithdiabetesinacovid19unitlessonslearnedfromapilotstudy
AT fuscopaolo characteristicsmanagementandoutcomesofelderlypatientswithdiabetesinacovid19unitlessonslearnedfromapilotstudy
AT lionellorosaria characteristicsmanagementandoutcomesofelderlypatientswithdiabetesinacovid19unitlessonslearnedfromapilotstudy
AT cancelliereanna characteristicsmanagementandoutcomesofelderlypatientswithdiabetesinacovid19unitlessonslearnedfromapilotstudy
AT procopiogiada characteristicsmanagementandoutcomesofelderlypatientswithdiabetesinacovid19unitlessonslearnedfromapilotstudy
AT lioelena characteristicsmanagementandoutcomesofelderlypatientswithdiabetesinacovid19unitlessonslearnedfromapilotstudy
AT trecarichienricomaria characteristicsmanagementandoutcomesofelderlypatientswithdiabetesinacovid19unitlessonslearnedfromapilotstudy
AT torticarlo characteristicsmanagementandoutcomesofelderlypatientswithdiabetesinacovid19unitlessonslearnedfromapilotstudy
AT iraceconcetta characteristicsmanagementandoutcomesofelderlypatientswithdiabetesinacovid19unitlessonslearnedfromapilotstudy