Risk and predictors of in-hospital mortality from COVID-19 in patients with diabetes and cardiovascular disease

Abstract

Background: Diabetes mellitus (DM) and cardiovascular disease (CVD) are present in a large number of patients with novel Coronavirus disease 2019 (COVID-19). We aimed to determine the risk and predictors of in-hospital mortality from COVID-19 in patients with DM and CVD.Methods: This retrospective cohort study included hospitalized patients aged ≥ 18 years with confirmed COVID-19 in Alborz province, Iran, from 20 February 2020 to 25 March 2020. Data on demographic, clinical and outcome (in-hospital mortality) data were obtained from electronic medical records. Self-reported comorbidities were classified into the following groups: “DM” (having DM with or without other comorbidities), “only DM” (having DM without other comorbidities), “CVD” (having CVD with or without other comorbidities), “only CVD” (having CVD without other comorbidities), and “having any comorbidity”. Multivariate logistic regression models were fitted to quantify the risk and predictors of in-hospital mortality from COVID-19 in patients with these comorbidities.Results: Among 2957 patients with COVID-19, 2656 were discharged as cured, and 301 died. In multivariate model, DM (OR: 1.62 (95%CI: 1.14-2.30)) and only DM (1.69 (1.05-2.74)) increased the risk of death from COVID-19; but, both CVD and only CVD showed non-significant associations (p>0.05). Moreover, “having any comorbidities” increased the risk of in-hospital mortality from COVID-19 (OR: 2.66 (95%CI: 2.09 -3.40)). Significant predictors of mortality from COVID-19 in patients with DM were lymphocyte count, creatinine and C-reactive protein (CRP) level (all P- values < 0.05).Conclusions: Our findings suggest that diabetic patients have an increased risk of in-hospital mortality following COVID-19; also, lymphocyte count, creatinine and CRP concentrations could be considered as significant predictors for the death of COVID-19 in these patients.

A call for strengthened evidence on targeted, non-pharmaceutical interventions against COVID-19 for the protection of vulnerable individuals in sub-Saharan Africa

“…Nevertheless, the region is home to more than 50 million elderly (aged 60 years and over) (United Nations, 2019), who can be considered at elevated risk of severe COVID-19 disease. Additionally, the continent has seen a steady increase in non-communicable diseases (NCD) such as diabetes (Ojuka and Goyaram, 2014) and hypertension (Bigna et al, 2017), which have been linked to COVID-19 severity (Rastad et al, 2020;Zhou et al, 2020). Furthermore, the continent carries a high burden of infectious diseases such as HIV and tuberculosis, which have been speculated to represent particular risk factors for severe COVID-19 disease as well (Davies, 2020).…”

ICU Stay and Mortality Between Vaccinated and Non-Vaccinated Patients of Covid-19; A comparative Study

“…Studies had found numerous parameters to be related with mortality in COVID-19. [8][9][10] A specific worry for COVID-19 vaccines is that a vaccine with great efficacy against COVID-19 disease (VEDIS) but low efficacy against SARS-CoV-2 infection (VESUSC), would largely convert symptomatic infections to asymptomatic infections. Furthermore, if the vaccination does not lower infectiousness (VEINF = 0), it might in theory lead to increased spread of SARS-CoV-2.…”

Comprehensive Evaluation of COVID-19 Patient Short- and Long-term Outcomes: Disparities in Healthcare Utilization and Post-Hospitalization Outcomes

“…The findings corroborate previous results for in-hospital mortality, which did not take into account patient discharge as a competing event. [91][92][93][94][95][96] To our knowledge, we are among the first few to consider discharge versus in-hospital mortality among COVID-19 patients under a competing risk regression framework. [57] Ignoring their competing relationship can lead to biased estimates of effects of risk factors for either event.…”