Study |
Population |
Main findings |
Wang F, et al.
Prospective observational, China.
|
28 patients with COVID-19 and diabetes.
|
A. Mean (SD) age 68.6 (9.0) years, 75% males.
B.17 (60.7%) had comorbidities: hypertension (53.6%), CVD (14.3%),
cerebrovascular disease (14.3%), chronic pulmonary disease (14.3%).
C. Common symptoms were: fever (92.9%), dry cough (82.1%), fatigue
(64.3%), dyspnoea (57.1%), anorexia (57.1%), diarrhoea (42.9%),
expectoration (25.0%) and nausea (21.4%).
C. 14 patients admitted to ICU, of whom 11 received non-invasive and 7
received mechanical ventilation.
D. 12 patients died in ICU, no mortality in non-ICU patients, with ICU
mortality rate 86% and overall mortality rate 43%.
E. Mean (SD) HbA1c 7.5% (1.2) in non-ICU and 7.3% (0.9) in ICU,
p=0.70.
F. Mean (SD) RBG 13.7 (5.1) in ICU vs 9.8 (3.4) in ICU patients,
P=0.03.
|
Yan Y, et al.
Retrospective observational, China.
|
193 patients with severe COVID-19, 48 with diabetes mellitus.
|
Patients with compared to those without diabetes were:
A. Significantly older, median (IQR) age 70 (62-77) vs 64 (49-73) years,
p<0.001.
B. Have more comorbidities (60.4% vs 44.8%, p=0.06), hypertension
(50% vs 33.8% < p=0.45), CVD (27.1% vs 12.4, p=0.016,
cerebrovascular disease (10.4% vs 2.1%, p=0.036).
C. Have significantly more ICU admission (66.7% vs 41.4%, p=0.002).
D. Required more mechanical ventilation (81.3% vs 49%,
p<0.001).
E. Significantly higher mortality (81.3% vs 47.6%, p<0.001).
F. Median (IQR) HbA1c 7.2% (6.7-8.3) vs 5.8% (5.5-6.1),
p<0.001.
|
Chen Y, et al.
Retrospective observational, China.
|
Total 904 patients with COVID-19, 136 with diabetes mellitus.
|
A. Patients with were significantly older than those without diabetes
(66 vs 56 years, p<0.001), had more history of hypertension
(61.2% vs 32.5%, p<0.001) and higher HbA1c (7.3% vs 5.9%,
p<0.001).
B. Risk factors for higher mortality of patients with diabetes were
older age (adjusted OR 1.09, 95% CI 1.04 to 1.15) per year increase;
P=0.001) and elevated CRP (1.12, 1.0 to 1.24, P=0.043).
C. Insulin usage was associated with poor prognosis defined as
progression to severe or critical illness (OR 3.58, 95% CI 1.37 to
9.35, P=0.009) but not with mortality.
D. ACEI or ARBs use had no impact on outcomes.
|
Holman N, et al
National diabetes and mortality data, England
|
265,090 people with type 1 and 2,889,210 with type 2 diabetes, all
covid-19 positive.
|
A. Mortality rate 0.16% in type 1 and 0.32% in type 2 diabetes.
B. Adjusted mortality HR of HbA1c >86 mmol/mol compared to
HbA1c 48-53 mmol/mol 2.19 (95% CI 1.46 to 3.29) for type 1 and 1.62
(1.48 to 1.79) for type 2 diabetes.
C. U-shaped relation between BMI and mortality, HRs for BMI
>40 kg/m2 compared to 25-29.9 kg/m2 2.15 (95% 1.37 to
3.36) and 1.46 (1.50 to 1.79) for type 1 and type 2 respectively.
|
Cariou B, et al
nationwide 53 centres, observational,
France
|
1,317 hospitalised patients with covid-19 and diabetes, primary outcome
mechanical ventilation and/or death within 7 days of admission.
|
A. Mean (SD) age 69.8 (13.0) years, 64.9% men, median BMI 28.4
(25th-75th percentile 25.0-32.7) kg/m², type 2
diabetes (88.5%).
B. Microvascular and macrovascular diabetic complications 46.8% and
40.8%, respectively.
C. Primary outcome encountered in 29.0% (95% CI 26.6 to 31.5),
mortality 10.6% (9.0 to 12.4), 18.0% (16.0 to 20.2) discharged on
day7.
D. In multivariable analyses, only BMI positively associated with
primary outcome (OR 1.28, 95% CI 1.10 to 1.47).
E. Age (OR 2.48, 95% CI 1.74 to 3.53), treated obstructive sleep apnoea
(2.80, 1.46 to 5.38), microvascular (2.14, 1.16 to 3.94) and
macrovascular complications (2.54, 1.44 to 4.50) were independently
associated with mortality risk on day 7.
|
Bode B, et al
retrospective observational
US
|
Total 1,122 patients in 88 US hospitals, 451 with diabetes or
uncontrolled hyperglycaemia.
|
A. mortality rate 28.8% in 184 diabetes and/or uncontrolled
hyperglycemia patients, compared to 6.2% of 386 patients without
diabetes or hyperglycemia (P <0.001).
B. Mortality rate 41.7% in uncontrolled hyperglycaemia and 14.8% in
diabetes patients, p<0.001.
C. LOS was longer in patients with uncontrolled hyperglycaemia or
diabetes compared to those without (5.7 vs 4.3 days,
p<0.001).
|