Diabetes Mellitus and Hypertension as Major Risk Factors of Mortality From Covid-19 Pneumonia

Petrakis, Vasileios; Panagopoulos, Periklis; Papazoglou, Dimitrios; Παπάνας, Νικόλαος

doi:10.1055/a-1325-0381

Cited by 16 publications

(14 citation statements)

References 10 publications

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“…Hypertension and diabetes mellitus increased susceptibility in SCAP, which they were consistent with our previous finding of SARS-CoV-2 in China [ 41 ] and Petrakisin’s in Greece [ 42 ]. Moreover, 45% of SCAP patients in our cohort were current smokers.…”

Section: Discussionsupporting

confidence: 92%

Aetiology of severe community acquired pneumonia in adults identified by combined detection methods: a multi-centre prospective study in China

Zhang

Chen

et al. 2022

Emerging Microbes & Infections

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Severe Community Acquired Pneumonia (SCAP) challenges public health globally. Considerable improvements in molecular pathogen testing emerged in the last few years. Our prospective study combinedly used traditional culture, antigen tests, PCR and mNGS in SCAP pathogen identification with clinical outcomes. From June 2018 to December 2019, we conducted a multi-centre prospective study in 17 hospitals of SCAP patients within 48 hours of emergency room stay or hospitalization in China. All clinical data were uploaded into an online database. Blood, urine and respiratory specimens were collected for routine culture, antigen detection, PCR and mNGS as designed appropriately. Aetiology confirmation was made by the local attending physician group and scientific committee according to microbiological results, clinical features, and response to the treatment. Two hundred seventy-five patients were included for final analysis. Combined detection methods made identification rate up to 74.2% (222/299), while 14.4% (43/299) when only using routine cultures and 40.8% (122/299) when not using mNGS. Influenza virus (23.2%, 46/198), S. pneumoniae (19.6%, 39/198), Enterobacteriaceae (14.6%, 29/198), Legionella pneumophila (12.6%, 25/198), Mycoplasma pneumoniae (11.1%, 22/198) were the top five common pathogens. The in-hospital mortality of patients with pathogen identified and unidentified was 21.7% (43/198) and 25.9% (20/77), respectively. In conclusion, early combined detection increased the pathogen identification rate and possibly benefitted survival. Influenza virus, S. pneumoniae , Enterobacteriaceae was the leading cause of SCAP in China, and there was a clear seasonal distribution pattern of influenza viruses. Physicians should be aware of the emergence of uncommon pathogens, including Chlamydia Psittaci and Leptospira .

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Section: Discussionsupporting

confidence: 92%

Aetiology of severe community acquired pneumonia in adults identified by combined detection methods: a multi-centre prospective study in China

Zhang

Chen

et al. 2022

Emerging Microbes & Infections

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“…Diabetes mellitus (DM) belongs to the comorbidities increasing the risk of severe COVID-19 pneumonia [2]. Notably, in our department among those who died from severe pneumonia, 71 % had DM [3].…”

Section: Dear Editormentioning

confidence: 76%

Diabetes Mellitus as the Major Factor of Prolonged Hospitalisation in Mild or Moderate COVID-19 Pneumonia

Petrakis

Trypsianis

Panagopoulos

et al. 2021

Exp Clin Endocrinol Diabetes

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“…Among the 69 patients with an ordinal score of 6 at baseline, those randomly assigned to the interferon beta-1a plus remdesivir group were more likely to be male (25 [71%] of 35 vs 19 [56%] of 34), present to hospital within 8 days of symptom onset (22 [63%] vs 15 [44%]), be older (median age 58·9 [SD 13·1] years vs 54·7 years [15·0]), have baseline D-dimer concentrations of ≥2·025 mg/L (eight [23%] vs six [18%]), and have baseline C-reactive protein concentrations of ≥100·0 mg/L (21 [60%] vs 16 [47%]) than those in the placebo plus remdesivir group ( appendix pp 26–27, 44, 96 ). Additionally, patients randomly assigned to the interferon beta-1a plus remdesivir group were more likely than those in the placebo plus remdesivir group to have comorbidities shown in other studies to be associated with severe disease: 18 , 19 , 20 type 2 diabetes (19 [54%] vs 11 [32%]), coronary artery disease (20 [60%] vs two [6%]), hypertension 25 [71%] vs 19 [56%]), chronic kidney disease (eight [24%] vs three [9%]), and obesity (21 [60%] vs 22 [65%]; appendix pp 25, 97 ). Univariate and multivariate Cox proportional hazards models were created, adjusting for these baseline characteristics for the primary endpoint, but all models yielded recovery rate ratios consistent with the estimated treatment effect in the primary unadjusted model, indicating worse outcomes with interferon beta-1a in those on high-flow oxygen at baseline ( appendix pp 36–37 ).…”

Section: Resultsmentioning

confidence: 99%

Efficacy of interferon beta-1a plus remdesivir compared with remdesivir alone in hospitalised adults with COVID-19: a double-blind, randomised, placebo-controlled, phase 3 trial

Kalil

Mehta

Patterson

et al. 2021

The Lancet Respiratory Medicine

143

117

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Background Functional impairment of interferon, a natural antiviral component of the immune system, is associated with the pathogenesis and severity of COVID-19. We aimed to compare the efficacy of interferon beta-1a in combination with remdesivir compared with remdesivir alone in hospitalised patients with COVID-19. Methods We did a double-blind, randomised, placebo-controlled trial at 63 hospitals across five countries (Japan, Mexico, Singapore, South Korea, and the USA). Eligible patients were hospitalised adults (aged ≥18 years) with SARS-CoV-2 infection, as confirmed by a positive RT-PCR test, and who met one of the following criteria suggestive of lower respiratory tract infection: the presence of radiographic infiltrates on imaging, a peripheral oxygen saturation on room air of 94% or less, or requiring supplemental oxygen. Patients were excluded if they had either an alanine aminotransferase or an aspartate aminotransferase concentration more than five times the upper limit of normal; had impaired renal function; were allergic to the study product; were pregnant or breast feeding; were already on mechanical ventilation; or were anticipating discharge from the hospital or transfer to another hospital within 72 h of enrolment. Patients were randomly assigned (1:1) to receive intravenous remdesivir as a 200 mg loading dose on day 1 followed by a 100 mg maintenance dose administered daily for up to 9 days and up to four doses of either 44 μg interferon beta-1a (interferon beta-1a group plus remdesivir group) or placebo (placebo plus remdesivir group) administered subcutaneously every other day. Randomisation was stratified by study site and disease severity at enrolment. Patients, investigators, and site staff were masked to interferon beta-1a and placebo treatment; remdesivir treatment was given to all patients without masking. The primary outcome was time to recovery, defined as the first day that a patient attained a category 1, 2, or 3 score on the eight-category ordinal scale within 28 days, assessed in the modified intention-to-treat population, defined as all randomised patients who were classified according to actual clinical severity. Safety was assessed in the as-treated population, defined as all patients who received at least one dose of the assigned treatment. This trial is registered with ClinicalTrials.gov , NCT04492475 . Findings Between Aug 5, 2020, and Nov 11, 2020, 969 patients were enrolled and randomly assigned to the interferon beta-1a plus remdesivir group (n=487) or to the placebo plus remdesivir group (n=482). The mean duration of symptoms before enrolment was 8·7 days (SD 4·4) in the interferon beta-1a plus remdesivir group and 8·5 days (SD 4·3) days in the placebo plus remdesivir group. Patients in both groups had a time to recovery of 5 days (95% CI not estimable) (rate ratio of interferon beta-1a plus remdesivir group vs plac...

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Diabetes Mellitus and Hypertension as Major Risk Factors of Mortality From Covid-19 Pneumonia

Cited by 16 publications

References 10 publications

Aetiology of severe community acquired pneumonia in adults identified by combined detection methods: a multi-centre prospective study in China

Aetiology of severe community acquired pneumonia in adults identified by combined detection methods: a multi-centre prospective study in China

Diabetes Mellitus as the Major Factor of Prolonged Hospitalisation in Mild or Moderate COVID-19 Pneumonia

Efficacy of interferon beta-1a plus remdesivir compared with remdesivir alone in hospitalised adults with COVID-19: a double-blind, randomised, placebo-controlled, phase 3 trial

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