Pneumonia mortality, comorbidities matter?

Hespanhol, Venceslau; Bárbara, Cristina

doi:10.1016/j.pulmoe.2019.10.003

Cited by 100 publications

(81 citation statements)

References 14 publications

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“…3 Diabetes is a primary risk factor for the development of severe pneumonia and sepsis because of virus infections and occurs in 20% of patients with severe pneumonia. 4,5 Hyperglycaemia and a history of type 2 diabetes are independent predictors of mortality and morbidity in patients with SARS. 6 Diabetes is also identified as a major contributor to disease severity and mortality in Middle East respiratory syndrome (MERS-CoV).…”

Section: Introductionmentioning

confidence: 99%

Newly diagnosed diabetes is associated with a higher risk of mortality than known diabetes in hospitalized patients with COVID‐19

Tian

Chen

et al. 2020

Diabetes Obesity Metabolism

244

266

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Aim To evaluate the association between different degrees of hyperglycaemia and the risk of all‐cause mortality among hospitalized patients with COVID‐19. Materials and Methods In a retrospective study conducted from 22 January to 17 March 2020, 453 patients were admitted to Union Hospital in Wuhan, China, with laboratory‐confirmed severe acute respiratory syndrome coronavirus 2 infection. Patients were classified into four categories: normal glucose, hyperglycaemia (fasting glucose 5.6‐6.9 mmol/L and/or HbA1c 5.7%‐6.4%), newly diagnosed diabetes (fasting glucose ≥7 mmol/L and/or HbA1c ≥6.5%) and known diabetes. The major outcomes included in‐hospital mortality, intensive care unit (ICU) admission and invasive mechanical ventilation (IMV). Results Patients with newly diagnosed diabetes constituted the highest percentage to be admitted to the ICU (11.7%) and require IMV (11.7%), followed by patients with known diabetes (4.1%; 9.2%) and patients with hyperglycaemia (6.2%; 4.7%), compared with patients with normal glucose (1.5%; 2.3%), respectively. The multivariable‐adjusted hazard ratios of mortality among COVID‐19 patients with normal glucose, hyperglycaemia, newly diagnosed diabetes and known diabetes were 1.00, 3.29 (95% confidence interval [CI] 0.65‐16.6), 9.42 (95% CI 2.18‐40.7) and 4.63 (95% CI 1.02‐21.0), respectively. Conclusion We showed that COVID‐19 patients with newly diagnosed diabetes had the highest risk of all‐cause mortality compared with COVID‐19 patients with known diabetes, hyperglycaemia and normal glucose. Patients with COVID‐19 need to be kept under surveillance for blood glucose screening.

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Section: Introductionmentioning

confidence: 99%

Newly diagnosed diabetes is associated with a higher risk of mortality than known diabetes in hospitalized patients with COVID‐19

Tian

Chen

et al. 2020

Diabetes Obesity Metabolism

244

266

View full text Add to dashboard Cite

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“…Accentuating the urgency for more knowledge are the recent pandemics caused by H1N1 influenza and SARS-CoV-2, which frequently result in concurrent viral and bacterial pneumonia [2][3][4]. There is evidence that viral and bacterial pneumonia share host vulnerabilities including winter season, older age, male sex, obesity, pre-existing cardiopulmonary conditions, and diabetes [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Increased Risk of Autopsy-Proven Pneumonia with Sex, Season and Neurodegenerative Disease

Beach¹,

Russell²,

Sue³

et al. 2021

Preprint

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There has been a markedly renewed interest in factors associated with pneumonia, a leading cause of death worldwide, due to its frequent concurrence with pandemics of influenza and Covid-19 disease. Reported predisposing factors to both bacterial pneumonia and pandemic viral lower respiratory infections are wintertime occurrence, older age, obesity, pre-existing cardiopulmonary conditions and diabetes. Also implicated are age-related neurodegenerative diseases that cause parkinsonism and dementia. We investigated the prevalence of autopsy-proven pneumonia in the Arizona Study of Aging and Neurodegenerative Disorders (AZSAND), a longitudinal clinicopathological study, between the years 2006 and 2019 and before the beginning of the Covid-19 pandemic. Of 691 subjects dying at advanced ages (mean 83.4), pneumonia was diagnosed postmortem in 343 (49.6%). There were 185 subjects without dementia or parkinsonism while clinicopathological diagnoses for the other subjects included 319 with Alzheimer’s disease dementia, 127 with idiopathic Parkinson’s disease, 72 with dementia with Lewy bodies, 49 with progressive supranuclear palsy and 78 with vascular dementia. Subjects with one or more of these neurodegenerative diseases all had higher pneumonia rates, ranging between 50 and 61%, as compared to those without dementia or parkinsonism (40%). In multivariable logistic regression models, male sex and a non-summer death both had independent contributions (ORs of 1.67 and 1.53) towards the presence of pneumonia at autopsy while the absence of parkinsonism or dementia was a significant negative predictor of pneumonia (OR 0.54). Male sex, dementia and parkinsonism may also be risk factors for Covid-19 pneumonia. The apolipoprotein E4 allele, as well as obesity, chronic obstructive pulmonary disease, diabetes, hypertension, congestive heart failure, cardiomegaly and cigarette smoking history, were not significantly associated with pneumonia, in contradistinction to what has been reported for Covid-19 disease.

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“…Type 2 diabetes mellitus (T2DM) is a prevalent disease globally. It has been recognized as a primary risk factor for the development of severe pneumonia due to respiratory viral infections [9]. A reciprocal interaction has been identified between COVID-19 and diabetes.…”

Section: Possible Pathophysiologic Links Between Diabetes and Covid-19mentioning

confidence: 99%

Challenging Issues in the Management of Cardiovascular Risk Factors in Diabetes During the COVID-19 Pandemic: A Review of Current Literature

et al. 2020

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The COVID-19 outbreak was declared a pandemic on March 2020. Many patients with SARS-CoV-2 infection have underlying chronic medical conditions such as diabetes, cardiovascular disease (CVD), and hypertension. Patient-related outcomes are worse if there are associated comorbidities. We do not have enough evidence regarding the most appropriate management of patients with diabetes during COVID-19 infection. Insulin resistance and CVD together increase the inflammatory state of the body, which can contribute to and perhaps mediate the increase of COVID-19 severity. Hence, in addition to management of dysglycemia, other CVD risk factors should be targeted. We explore the possible pathophysiologic links between diabetes and COVID-19 and discuss various options to treat dysglycemia, hypertension, and dyslipidemia in the era of COVID-19.

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Pneumonia mortality, comorbidities matter?

Cited by 100 publications

References 14 publications

Newly diagnosed diabetes is associated with a higher risk of mortality than known diabetes in hospitalized patients with COVID‐19

Newly diagnosed diabetes is associated with a higher risk of mortality than known diabetes in hospitalized patients with COVID‐19

Increased Risk of Autopsy-Proven Pneumonia with Sex, Season and Neurodegenerative Disease

Challenging Issues in the Management of Cardiovascular Risk Factors in Diabetes During the COVID-19 Pandemic: A Review of Current Literature

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