Association of Blood Glucose Control and Outcomes in Patients with COVID-19 and Pre-existing Type 2 Diabetes

Zhu, Lihua; She, Zhi Gang; Xu, Cheng; Qin, Juan Juan; Zhang, Xiao Jing; Cai, Jingjing; Lei, Fang; Wang, Haitao; Xie, Jing; Wang, Wenxin; Li, Haomiao; Zhang, Peng; Song, Xiaohui; Chen, Xi; Xiang, Min; Zhang, Chaozheng; Bai, Lei; Da, Xiang; Chen, Ming Ming; Liu, Yanqiong; Yan, Youqin; Li, Mingyu; Mao, Weiming; Zou, Jinjing; Li, Liming; Chen, Guohua; Luo, Pengfei; Xiao, Bing; Zhang, Changjiang; Zhang, Zixiong; Lu, Zhigang; Wang, Junhai; Lu, Haofeng; Xia, Xin; Wang, Daihong; Liao, Xiaofeng; Peng, Gang; Ye, Ping; Yang, Jun; Yuan, Yufeng; Huang, Xiaodong; Guo, Jiao; Zhang, Bing Hong; Li, Hongliang

doi:10.1016/j.cmet.2020.04.021

Cited by 1,417 publications

(1,694 citation statements)

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“…In this study which had relatively rich clinical data, we found that diabetes alone was not the independent risk factors for in-hospital mortality of COVID-19, but comorbidities such as hypertension, CKD were risk factors, this result was consistent with the previous study [13]. Partially consistent with the previous studies, our study found that, compared with non-diabetic patients, diabetic COVID-19 patients were older, had worse outcome including higher rate of mortality, severe cases and ARDS, presented severe in ammation response, lung and coagulation dysfunction [2,11,12,14]. Additionally, diabetic patients had increased level of urea nitrogen and decreased level of albumin.…”

Section: Discussionsupporting

confidence: 92%

“…Lots of studies had demonstrated that diabetic patients had higher risk of mortality in COVID, as well as developing more severe cases [2,4,11,12]. Guo et al [12] reported that diabetes was a risk factor for the progression and prognosis of COVID-19.…”

Section: Discussionmentioning

confidence: 99%

“…Acute kidney injury (AKI) was diagnosed according to the KDIGO clinical practice guideline [9]. Acute cardiac injury (ACI) was reported if serum levels of myocardial injury biomarkers were higher than the upper limit of normal [2]. The criteria for classi cation of COVID-19 severity was according to the Diagnosis and Treatment Protocol for COVID-…”

Section: Data Collectionmentioning

confidence: 99%

“…As of Jun 27, 2020, more than nine million COVID-19 cases have been con rmed around the world, and nearly 480,000 patients died of COVID-19 (http://www.who.int/emergencies /diseases/novel -coronavirus-2019 situation -reports). Wellcontrolled blood glucose of pre-existing diabetes was associated with a signi cant reduction in the composite adverse outcomes and death of COVID-19 patients [2]. As we all known, patients with diabetes often had several comorbidities, and previous research had revealed that hypertension, chronic obstructed pneumonia disease (COPD),chronic kidney disease (CKD), cardiovascular disease and cerebrovascular disease (CVD) were also associated with worse outcome in patients suffered with COVID-19 [3][4][5][6].…”

Section: Introductionmentioning

confidence: 95%

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Diabetic Patients with Comorbidities had Worse Outcomes When Suffered with COVID-19 and Acarbose might have Protective Effects

Luo

et al. 2020

Preprint

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Background: Previous studies showed that diabetes was a common comorbidity of COVID-19, but the effects of diabetes or anti-diabetic drugs on the mortality of COVID-19 have not been well described. To investigate the outcome of different status (with or without comorbidity) and anti-diabetic medication before admission of diabetic patients after SARS-CoV-2 infected, we collected clinical data of COVID-19 patients from Hubei Province and compared between diabetes and non-diabetes.Methods: In this multicenter and retrospective study, we enrolled 1,422 cases of consecutive hospitalized patients from January 21, 2020 to March 25, 2020 at six hospitals in Hubei Province, China. The primary endpoint was in-hospital mortality.Results: Diabetes patients were 10-years older than non-diabetes (p<0.001), had higher prevalence of comorbidities such as hypertension (p<0.001), coronary heart disease (p<0.001), cerebrovascular disease (CVD) (p<0.001), chronic kidney disease (CKD) (p=0.007). The incidence of mortality (p=0.003) were more prevalent among the diabetes group. Further analysis revealed that diabetes patients who took alpha-glucosidase inhibitor (AGI) had lower mortality rate(p<0.01). Multivariable Cox regression showed that male sex, hypertension, CKD, CVD, age were risk factors for the mortality of COVID-19. Survival curve revealed that, compared with diabetes only group, the mortality was increased in diabetes with comorbidities (p=0.009), but had no significant difference in the non-comorbidity group, p=0.59).Conclusions: Patients with diabetes had worse outcome when suffered with COVID-19, however, it was not associated with diabetes itself but the comorbidities. Furthermore, the administration of AGI could reduce the risk of death in patients with diabetes.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Data Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

See 2 more Smart Citations

Diabetic Patients with Comorbidities had Worse Outcomes When Suffered with COVID-19 and Acarbose might have Protective Effects

Luo

et al. 2020

Preprint

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“…Afterward, based on the cause of their wound, we classi ed patients with chronic wounds as gangrene due to vascular occlusion, ulcers due to traumatic infection, and other types of soft tissue infection wound due to bedsores, gout ruptures, stabbing. Risk factors for coronavirus were limited to advanced age (≥ 60 years), hypertension, diabetes, renal damage, and cardiovascular disease according to the available studies (3,11,27).…”

Section: Methodsmentioning

confidence: 99%

Exposure risk of patients with chronic infectious wounds during the COVID-19 outbreak and its countermeasures

Zhou

Jin

Lü

2020

Preprint

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BACKGROUND A large number of cases of pneumonia caused by novel β-coronavirus emerged in Hubei Province, China, at the end of 2019 and demonstrated great potential for transmission. At present, known independent risk factors include age, diabetes and other chronic diseases, which may be similar to the patients with chronic wound, thus we try to explore the clinical characteristics, prognostic factors and management recommendation of patients with chronic infective wounds during the COVID-19 epidemic period. METHODS In this single-center, retrospective observational study, we included all cases with chronic infective wounds that came to our hospital between the full outbreak of the COVID-19 in China (January 23, 2020) and the latest date prior to posting (20 April 2020). Demographic data, comorbidities, laboratory and imaging findings, consultation history and clinical outcomes (lesion cured, uncontrolled, amputated, etc. as of May 10, 2020) were collected for all individuals. Patients were subdivided into gangrene, traumatic infection and other types of soft tissue infection wound (including bedsores, gout ruptures, stab wounds and so on) according to the causes of wound and their disease-related information were compared group by group. RESULTS Among the total 81 patients with chronic infective wounds, 60% was male, with a mean age of 60.8 years (SD 18.6), including 38 (47%) patients with traumatic infection, 29 (36%) gangrene cases, and 14 (17%) other soft tissue infection wounds. Common comorbidities are hypertension (32%), diabetes (32%), cardiovascular disease (24%), and kidney injury (12%), and the patients with gangrenes have the most comorbidities. As of May 10, 2020, there were 78 patients discharged and their average stay time is 15.8 days(SD 14.2), while people still at the hospital is 39.7days(SD 8.7)much longer than the discharged and also has more comorbidities. But there is no significant difference in the hospitalization time of three types of wounds. And fortunately, none of all the patients were infected by coronavirus. CONCLUSION The majority of patients with chronic wounds are severely ill with high risk of infection and poor prognosis, therefore management of patients with chronic wounds should be improved.

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Metabolic Syndrome and Acute Respiratory Distress Syndrome in Hospitalized Patients With COVID-19

Denson

Gillet²,

et al. 2021

JAMA Netw Open

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IMPORTANCE Obesity, diabetes, and hypertension are common comorbidities in patients with severe COVID-19, yet little is known about the risk of acute respiratory distress syndrome (ARDS) or death in patients with COVID-19 and metabolic syndrome. OBJECTIVE To determine whether metabolic syndrome is associated with an increased risk of ARDS and death from COVID-19. DESIGN, SETTING, AND PARTICIPANTS This multicenter cohort study used data from the Society of Critical Care Medicine Discovery Viral Respiratory Illness Universal Study collected from 181 hospitals across 26 countries from February 15, 2020, to February 18, 2021. Outcomes were compared between patients with metabolic syndrome (defined as Ն3 of the following criteria: obesity, prediabetes or diabetes, hypertension, and dyslipidemia) and a control population without metabolic syndrome. Participants included adult patients hospitalized for COVID-19 during the study period who had a completed discharge status. Data were analyzed from February 22 to October 5, 2021. EXPOSURES Exposures were SARS-CoV-2 infection, metabolic syndrome, obesity, prediabetes or diabetes, hypertension, and/or dyslipidemia. MAIN OUTCOMES AND MEASURESThe primary outcome was in-hospital mortality. Secondary outcomes included ARDS, intensive care unit (ICU) admission, need for invasive mechanical ventilation, and length of stay (LOS). RESULTSAmong 46 441 patients hospitalized with COVID-19, 29 040 patients (mean [SD] age, 61.2 [17.8] years; 13 059 [45.0%] women and 15713 [54.1%] men; 6797 Black patients [23.4%], 5325 Hispanic patients [18.3%], and 16 507 White patients [57.8%]) met inclusion criteria. A total of 5069 patients (17.5%) with metabolic syndrome were compared with 23 971 control patients (82.5%) without metabolic syndrome. In adjusted analyses, metabolic syndrome was associated with

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Association of Blood Glucose Control and Outcomes in Patients with COVID-19 and Pre-existing Type 2 Diabetes

Cited by 1,417 publications

References 35 publications

Diabetic Patients with Comorbidities had Worse Outcomes When Suffered with COVID-19 and Acarbose might have Protective Effects

Diabetic Patients with Comorbidities had Worse Outcomes When Suffered with COVID-19 and Acarbose might have Protective Effects

Exposure risk of patients with chronic infectious wounds during the COVID-19 outbreak and its countermeasures

Metabolic Syndrome and Acute Respiratory Distress Syndrome in Hospitalized Patients With COVID-19

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