Objectives To characterise the clinical features of hospitalised COVID 19 patients in a single centre during the first epidemic wave and explore potential predictive variables associated with outcomes such as mortality and the need for mechanical ventilation, using baseline clinical parameters. Methodology We conducted a retrospective review of electronic records for demographic, clinical and laboratory data, imaging and outcomes for 500 hospitalised patients between February 20th and May 7th 2020 from Southend University Hospital, Essex, UK. Multivariate logistic regression models were used to identify risk factors relevant to outcome. Results The mean age of the cohort admitted to hospital with Covid-19, was 69.4 and 290 (58%) were over 70. The majority were Caucasians, 437 (87%) with less than 2 co-morbidities 280(56%). Most common were hypertension 186(37 %), Cardiovascular disease 178(36 %) and Diabetes 128 (26 %), represented in a larger proportion on the mortality group. Mean CFS was 4 with Non Survivors had significantly higher CFS 5 vs 3 in survivors, p<0.001. In addition, Mean CRP was significantly higher 150 vs 90, p<0.001 in Non Survivors. We observed the baseline predictors for mortality were age, CFS and CRP. Conclusions In this single centre study, older and frailer patients with more comorbidities and a higher baseline CRP and creatinine were risk factors for worse outcomes. Integrated frailty and age based risk stratification are essential, in addition to monitoring SFR (Sp02/Fi02) and inflammatory markers throughout the disease course to allow for early intervention to improve patient outcomes.

Gestational diabetes mellitus (GDM) is recognized as one of the most common medical complications of pregnancy that can lead to significant short-term and long-term risks for the mother and the fetus if not detected early and treated appropriately. Current evidence suggests that, with the use of appropriate screening programs for GDM, those women diagnosed and treated have reduced perinatal morbidity. It has been implied that, when screening for GDM, there should be uniformity in the testing used and in further management. This paper summarizes and compares current screening strategies proposed by international bodies and discusses application in the context of the COVID-19 pandemic.

Aim To explore potential predictive variables associated with outcomes using baseline clinical parameters in 500 hospitalised COVID-19 patients. Findings Older age, clinical frailty score and C-reactive protein are independent predictors of mortality. Message Integrated frailty and age-based risk stratification are essential to allow for early intervention to improve patient outcomes.

In type 1 diabetes patients insulin resistance was the most important independent risk factor associated with diabetic proliferative retinopathy.

Background and Aims. Insulin resistance is documented in type 1 diabetes and it has been associated with chronic complications. Diabetic nephropathy is a major cause of morbidity and mortality. The purpose of this article is to quantify insulin resistance in type 1 diabetes subjects according to the presence or absence of advanced renal disease. A secondary objective was to study the possible association between insulin resistance and advanced renal disease.Material and Methods. This was a cross-sectional study that included 167 type 1 diabetes patients. Insulin resistance was determined using the eGDR (estimated glucose disposal rate) formula. The association between eGDR and diabetic nephropathy was assessed in uni and multivariate models using stepwise logistic regression analysis of variables. The contribution of individual predictors in the final regression model was examined using Wald statistic.Results. Significantly lower eGDR’s values were observed in patients with nephropathy: 5 vs. 7.3 (p<0.001). In univariate analysis eGDR was significantly associated with diabetic nephropathy (p<0.001). eGDR variable was retained in the final model of stepwise logistic regression (p<0.001) and showed the strongest association with diabetic nephropathy (Wald = 30.4).Conclusions. In type 1 diabetes patients insulin resistance was the most important independent risk factor associated with advanced renal disease.