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Diabetes IN hospital – Glucose and Outcomes in the COVID‐19 pandemic (DINGO COVID‐19): the 2020 Melbourne hospital experience prior to novel variants and vaccinations

BACKGROUND AND AIMS: A relationship between diabetes, glucose and COVID‐19 outcomes has been reported in international cohorts. This study aimed to assess the relationship between diabetes, hyperglycaemia and patient outcomes in those hospitalised with COVID‐19 during the first year of the Victorian...

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Autores principales: Barmanray, Rahul D., Gong, Joanna Y., Kyi, Mervyn, Kevat, Dev, Islam, Mohammad A., Galligan, Anna, Manos, Georgina R., Nair, Indu V., Perera, Nayomi, Adams, Nicholas K., Nursing, Ashvin, Warren, Annabelle M., Hamblin, Peter S., MacIsaac, Richard J., Ekinci, Elif I., Krishnamurthy, Balasubramanian, Karunajeewa, Harin, Buising, Kirsty, Visvanathan, Kumar, Kay, Thomas W. H., Fourlanos, Spiros
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9874487/
https://www.ncbi.nlm.nih.gov/pubmed/36269315
http://dx.doi.org/10.1111/imj.15937
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author Barmanray, Rahul D.
Gong, Joanna Y.
Kyi, Mervyn
Kevat, Dev
Islam, Mohammad A.
Galligan, Anna
Manos, Georgina R.
Nair, Indu V.
Perera, Nayomi
Adams, Nicholas K.
Nursing, Ashvin
Warren, Annabelle M.
Hamblin, Peter S.
MacIsaac, Richard J.
Ekinci, Elif I.
Krishnamurthy, Balasubramanian
Karunajeewa, Harin
Buising, Kirsty
Visvanathan, Kumar
Kay, Thomas W. H.
Fourlanos, Spiros
author_facet Barmanray, Rahul D.
Gong, Joanna Y.
Kyi, Mervyn
Kevat, Dev
Islam, Mohammad A.
Galligan, Anna
Manos, Georgina R.
Nair, Indu V.
Perera, Nayomi
Adams, Nicholas K.
Nursing, Ashvin
Warren, Annabelle M.
Hamblin, Peter S.
MacIsaac, Richard J.
Ekinci, Elif I.
Krishnamurthy, Balasubramanian
Karunajeewa, Harin
Buising, Kirsty
Visvanathan, Kumar
Kay, Thomas W. H.
Fourlanos, Spiros
author_sort Barmanray, Rahul D.
collection PubMed
description BACKGROUND AND AIMS: A relationship between diabetes, glucose and COVID‐19 outcomes has been reported in international cohorts. This study aimed to assess the relationship between diabetes, hyperglycaemia and patient outcomes in those hospitalised with COVID‐19 during the first year of the Victorian pandemic prior to novel variants and vaccinations. DESIGN, SETTING: Retrospective cohort study from March to November 2020 across five public health services in Melbourne, Australia. PARTICIPANTS: All consecutive adult patients admitted to acute wards of participating institutions during the study period with a diagnosis of COVID‐19, comprising a large proportion of patients from residential care facilities and following dexamethasone becoming standard‐of‐care. Admissions in patients without known diabetes and without inpatient glucose testing were excluded. RESULTS: The DINGO COVID‐19 cohort comprised 840 admissions. In 438 admissions (52%), there was no known diabetes or in‐hospital hyperglycaemia, in 298 (35%) patients had known diabetes, and in 104 (12%) patients had hyperglycaemia without known diabetes. ICU admission was more common in those with diabetes (20%) and hyperglycaemia without diabetes (49%) than those with neither (11%, P < 0.001 for all comparisons). Mortality was higher in those with diabetes (24%) than those without diabetes or hyperglycaemia (16%, P = 0.02) but no difference between those with in‐hospital hyperglycaemia and either of the other groups. On multivariable analysis, hyperglycaemia was associated with increased ICU admission (adjusted odds ratio (aOR) 6.7, 95% confidence interval (95% CI) 4.0–12, P < 0.001) and longer length of stay (aOR 173, 95% CI 11–2793, P < 0.001), while diabetes was associated with reduced ICU admission (aOR 0.55, 95% CI 0.33–0.94, P = 0.03). Neither diabetes nor hyperglycaemia was independently associated with in‐hospital mortality. CONCLUSIONS: During the first year of the COVID‐19 pandemic, in‐hospital hyperglycaemia and known diabetes were not associated with in‐hospital mortality, contrasting with published international experiences. This likely mainly relates to hyperglycaemia indicating receipt of mortality‐reducing dexamethasone therapy. These differences in published experiences underscore the importance of understanding population and clinical treatment factors affecting glycaemia and COVID‐19 morbidity within both local and global contexts.
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spelling pubmed-98744872023-01-25 Diabetes IN hospital – Glucose and Outcomes in the COVID‐19 pandemic (DINGO COVID‐19): the 2020 Melbourne hospital experience prior to novel variants and vaccinations Barmanray, Rahul D. Gong, Joanna Y. Kyi, Mervyn Kevat, Dev Islam, Mohammad A. Galligan, Anna Manos, Georgina R. Nair, Indu V. Perera, Nayomi Adams, Nicholas K. Nursing, Ashvin Warren, Annabelle M. Hamblin, Peter S. MacIsaac, Richard J. Ekinci, Elif I. Krishnamurthy, Balasubramanian Karunajeewa, Harin Buising, Kirsty Visvanathan, Kumar Kay, Thomas W. H. Fourlanos, Spiros Intern Med J Original Articles BACKGROUND AND AIMS: A relationship between diabetes, glucose and COVID‐19 outcomes has been reported in international cohorts. This study aimed to assess the relationship between diabetes, hyperglycaemia and patient outcomes in those hospitalised with COVID‐19 during the first year of the Victorian pandemic prior to novel variants and vaccinations. DESIGN, SETTING: Retrospective cohort study from March to November 2020 across five public health services in Melbourne, Australia. PARTICIPANTS: All consecutive adult patients admitted to acute wards of participating institutions during the study period with a diagnosis of COVID‐19, comprising a large proportion of patients from residential care facilities and following dexamethasone becoming standard‐of‐care. Admissions in patients without known diabetes and without inpatient glucose testing were excluded. RESULTS: The DINGO COVID‐19 cohort comprised 840 admissions. In 438 admissions (52%), there was no known diabetes or in‐hospital hyperglycaemia, in 298 (35%) patients had known diabetes, and in 104 (12%) patients had hyperglycaemia without known diabetes. ICU admission was more common in those with diabetes (20%) and hyperglycaemia without diabetes (49%) than those with neither (11%, P < 0.001 for all comparisons). Mortality was higher in those with diabetes (24%) than those without diabetes or hyperglycaemia (16%, P = 0.02) but no difference between those with in‐hospital hyperglycaemia and either of the other groups. On multivariable analysis, hyperglycaemia was associated with increased ICU admission (adjusted odds ratio (aOR) 6.7, 95% confidence interval (95% CI) 4.0–12, P < 0.001) and longer length of stay (aOR 173, 95% CI 11–2793, P < 0.001), while diabetes was associated with reduced ICU admission (aOR 0.55, 95% CI 0.33–0.94, P = 0.03). Neither diabetes nor hyperglycaemia was independently associated with in‐hospital mortality. CONCLUSIONS: During the first year of the COVID‐19 pandemic, in‐hospital hyperglycaemia and known diabetes were not associated with in‐hospital mortality, contrasting with published international experiences. This likely mainly relates to hyperglycaemia indicating receipt of mortality‐reducing dexamethasone therapy. These differences in published experiences underscore the importance of understanding population and clinical treatment factors affecting glycaemia and COVID‐19 morbidity within both local and global contexts. John Wiley & Sons Australia, Ltd 2022-10-21 2023-01 /pmc/articles/PMC9874487/ /pubmed/36269315 http://dx.doi.org/10.1111/imj.15937 Text en © 2022 The Authors. Internal Medicine Journal published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Physicians. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Barmanray, Rahul D.
Gong, Joanna Y.
Kyi, Mervyn
Kevat, Dev
Islam, Mohammad A.
Galligan, Anna
Manos, Georgina R.
Nair, Indu V.
Perera, Nayomi
Adams, Nicholas K.
Nursing, Ashvin
Warren, Annabelle M.
Hamblin, Peter S.
MacIsaac, Richard J.
Ekinci, Elif I.
Krishnamurthy, Balasubramanian
Karunajeewa, Harin
Buising, Kirsty
Visvanathan, Kumar
Kay, Thomas W. H.
Fourlanos, Spiros
Diabetes IN hospital – Glucose and Outcomes in the COVID‐19 pandemic (DINGO COVID‐19): the 2020 Melbourne hospital experience prior to novel variants and vaccinations
title Diabetes IN hospital – Glucose and Outcomes in the COVID‐19 pandemic (DINGO COVID‐19): the 2020 Melbourne hospital experience prior to novel variants and vaccinations
title_full Diabetes IN hospital – Glucose and Outcomes in the COVID‐19 pandemic (DINGO COVID‐19): the 2020 Melbourne hospital experience prior to novel variants and vaccinations
title_fullStr Diabetes IN hospital – Glucose and Outcomes in the COVID‐19 pandemic (DINGO COVID‐19): the 2020 Melbourne hospital experience prior to novel variants and vaccinations
title_full_unstemmed Diabetes IN hospital – Glucose and Outcomes in the COVID‐19 pandemic (DINGO COVID‐19): the 2020 Melbourne hospital experience prior to novel variants and vaccinations
title_short Diabetes IN hospital – Glucose and Outcomes in the COVID‐19 pandemic (DINGO COVID‐19): the 2020 Melbourne hospital experience prior to novel variants and vaccinations
title_sort diabetes in hospital – glucose and outcomes in the covid‐19 pandemic (dingo covid‐19): the 2020 melbourne hospital experience prior to novel variants and vaccinations
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9874487/
https://www.ncbi.nlm.nih.gov/pubmed/36269315
http://dx.doi.org/10.1111/imj.15937
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