Biomarkers Predictive for In-Hospital Mortality in Patients with Diabetes Mellitus and Prediabetes Hospitalized for COVID-19 in Austria: An Analysis of COVID-19 in Diabetes Registry

Abstract

Background: This study assessed the predictive performance of inflammatory, hepatic, coagulation, and cardiac biomarkers in patients with prediabetes and diabetes mellitus hospitalized for COVID-19 in Austria. Methods: This was an analysis of a multicenter cohort study of 747 patients with diabetes mellitus or prediabetes hospitalized for COVID-19 in 11 hospitals in Austria. The primary outcome of this study was in-hospital mortality. The predictor variables included demographic characteristics, clinical parameters, comorbidities, use of medication, disease severity, and laboratory measurements of biomarkers. The association between biomarkers and in-hospital mortality was assessed using simple and multiple logistic regression analyses. The predictive performance of biomarkers was assessed using discrimination and calibration. Results: In our analysis, 70.8% had type 2 diabetes mellitus, 5.8% had type 1 diabetes mellitus, 14.9% had prediabetes, and 8.6% had other types of diabetes mellitus. The mean age was 70.3 ± 13.3 years, and 69.3% of patients were men. A total of 19.0% of patients died in the hospital. In multiple logistic regression analysis, LDH, CRP, IL-6, PCT, AST-ALT ratio, NT-proBNP, and Troponin T were significantly associated with in-hospital mortality. The discrimination of NT-proBNP was 74%, and that of Troponin T was 81%. The calibration of NT-proBNP was adequate (p = 0.302), while it was inadequate for Troponin T (p = 0.010). Conclusion: Troponin T showed excellent predictive performance, while NT-proBNP showed good predictive performance for assessing in-hospital mortality in patients with diabetes mellitus hospitalized with COVID-19. Therefore, these cardiac biomarkers may be used for prognostication of COVID-19 patients.

An Updated Systematic Review and Meta-Analysis of the Association between the De Ritis Ratio and Disease Severity and Mortality in Patients with COVID-19

“…Two studies had a prospective study design [45,53], whilst the remaining 22 were retrospective [30][31][32][33][34][46][47][48][49][50][51][52][54][55][56][57][58][59][60][61][62][63]. The clinical endpoints assessed included mortality (15 studies) [30][31][32][33][34][46][47][48][50][51][52][54][55][56]62] and the following measures of severe disease: clinical severity based on existing guidelines (8 studies) [33,45,49,53,[56][57][58][59], transfer to the ICU (two studies) [56,62], persistent viral positivity (one study) [6...…”

“…Of them, 4757 were either duplicates or irrelevant and, therefore, excluded. After a full review of the remaining 27 articles, three were excluded because they did not meet the inclusion criteria, leaving 24 articles for analysis ( Figure 1 ) [ 30 , 31 , 32 , 33 , 34 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 ].…”

“…Of them, 4757 were either duplicates or irrelevant and, therefore, excluded. After a full review of the remaining 27 articles, three were excluded because they did not meet the inclusion criteria, leaving 24 articles for analysis (Figure 1) [30][31][32][33][34][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63]. Two studies had a prospective study design [45,53], whilst the remaining 22 were retrospective [30][31][32][33][34][46][47][48][49][50][51][52][54][55][56][57][58][59][60][61][62][63].…”

Circulating mid-regional proadrenomedullin is a predictor of mortality in patients with COVID-19: a systematic review and meta-analysis

“…The study population we included had different severities of illness, and the overall mortality rate was 19%. Many studies have used various biomarkers, such as CRP [ 39 – 44 ], PCT [ 39 , 43 , 45 , 46 ], IL-6 [ 39 , 43 , 46 ], WBC [ 40 , 47 – 49 ], D-dimer [ 42 , 44 , 46 , 50 , 51 ], lactate dehydrogenase (LDH) [ 39 , 42 – 44 , 46 , 47 ], N-terminal pro-B-type natriuretic peptide (NT-proBNP) [ 39 , 52 , 53 ], and Troponin T [ 39 , 54 ], and critical illness scores, such as APACHE II [ 55 – 57 ], SOFA [ 55 , 56 , 58 – 60 ], SAPS [ 61 – 64 ], and CURB65 [ 59 , 61 , 65 ], to evaluate the prognosis of patients with COVID-19. The APACHE II and SOFA scoring systems require the worst values of the clinical and biological parameters to be recorded within 24 h of admission [ 66 ].…”

Circulating Mid-regional Proadrenomedullin is a predictor of mortality in patients with COVID-19: a systematic review and meta-analysis

“…The study population we included had different severities of illness, and the overall mortality rate was 19%. Many studies have used various biomarkers, such as CRP [39][40][41][42][43][44], PCT [39,43,45,46], IL-6 [39,43,46], WBC [40,[47][48][49], D-dimer [42,44,46,50,51], lactate dehydrogenase (LDH) [39,[42][43][44]46,47], N-terminal pro-B-type natriuretic peptide (NT-proBNP) [39,52,53], and Troponin T [39,54], and critical illness score, such as APACHEII [55][56][57], SOFA [55,56,[58][59][60], SAPS [61-64], and CURB65 [59,61,65], to evaluate the prognosis of patients with COVID-19. The APACHE II and SOFA scoring systems require the worst values of the clinical and biological parameters to be recorded within 24 h of admission [66].…”