The Risk of Diabetes on Clinical Outcomes in Patients with Coronavirus Disease 2019: A Retrospective Cohort Study

Chung, Seung Min; Lee, Yin Young; Ha, Eun Yeong; Yoon, Ji Sung; Won, Kyu Chang; Lee, Hyoung Woo; Hur, Jun; Hong, Kyung Soo; Jang, Jong Geol; Jin, Hyun Jung; Choi, Eun Young; Shin, Kyeong Cheol; Chung, Jin Hong; Lee, Kwan Ho; Ahn, Jae‐Jun; Moon, Jun Sung

doi:10.4093/dmj.2020.0105

Cited by 62 publications

(79 citation statements)

References 26 publications

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“…Interestingly, multivariate logistic regression analysis revealed that an age of ≥70 years and a high serum LDH level significantly predicted mortality among hospitalized COVID-19 patients with diabetes. Similarly, other studies have reported that an age of >60 years is a major predictor of disease severity and mortality among diabetic COVID-19 patients [16,17]. A growing body of literatures supported an age of ≥70 years' patients with COVID-19 had incremental severity and mortality than younger ones [23,27].…”

Section: Discussionmentioning

confidence: 74%

“…Several systematic reviews and meta-analyses [15,16], cohort [14,17], case-control [12], and cross-sectional studies [16,18] have demonstrated that diabetic patients with COVID-19 are at considerably greater risk of mortality and of developing more severe disease than COVID-19 patients without diabetes. However, it was reported in a recent study that diabetes had no effect on the prognosis of COVID-19 patients but was negatively associated with clinical outcomes [19], which indicated studies are needed to narrow gaps in our understanding of the disease, and thus, aid decision-making by health care providers and administrators.…”

Section: Introductionmentioning

confidence: 99%

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Mortality Rate and Predictors of Mortality in Hospitalized COVID-19 Patients with Diabetes

Acharya

Lee

et al. 2020

Healthcare

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Studies have confirmed COVID-19 patients with diabetes are at higher risk of mortality than their non-diabetic counterparts. However, data-driven evidence of factors associated with increased mortality risk among hospitalized COVID-19 patients with diabetes is scarce in South Korea. This study was conducted to determine the mortality rate and identify risk factors of mortality among hospitalized COVID-19 patients with type 2 diabetes in Gyeongsangbuk-do province, South Korea. In this hospital-based, cross-sectional study, we enrolled a total of 324 patients with confirmed COVID-19, hospitalized at two of the tertiary level healthcare facilitates of Gyeongsangbuk-do, South Korea from 18 February to 30 June 2020. Demographic and clinical data and laboratory profiles were analyzed and multivariate logistic regression analysis was used to identify risk factors of mortality among diabetic patients with COVID-19. Of the 324 patients, 55 (16.97%) had diabetes mellitus. The mean age of all study subjects was 55 years, and the mean age of those with diabetes was greater than that of those without (69.8 years vs. 51.9 years). Remarkably, the mortality rate was much higher among those with diabetes (20.0% vs. 4.8%). Multivariate logistic regression analysis revealed that an older age (≥70 years) and a high serum lactate dehydrogenase (LDH) levels significantly predicted mortality among hospitalized COVID-19 patients with diabetes. Our study cautions more attention to be paid to patients with diabetes mellitus hospitalized for COVID-19, especially those aged ≥ 70 years and those with a high serum LDH level, to reduce the risk of mortality.

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Section: Discussionmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Mortality Rate and Predictors of Mortality in Hospitalized COVID-19 Patients with Diabetes

Acharya

Lee

et al. 2020

Healthcare

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“…Mortality among patients with diabetes was 19.3%, whereas previous studies have reported rates from 7.3% to 81.3%. 25 26 27 28 29 Several factors such as an impaired immune system, a pre-existing proinflammatory state, direct pancreatic damage, and dysregulation of ACE2 signaling have been suggested to contribute to the association between diabetes and COVID-19. 30 31 Cancer patients tend to be immunocompromised and at increased risk of serious COVID-19-related events.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Mortality Predictors of COVID-19 Patients Hospitalized at Nationally-Designated Treatment Hospitals

et al. 2020

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Background Coronavirus disease 2019 (COVID-19) was first reported in December 2019 in China, and then it has disseminated worldwide. In Korea, a religious group-related super-spreading event triggered a sudden outbreak in Daegu city and Gyeongsangbuk-do in southeast Korea. This study was undertaken to document the clinical characteristics of patients hospitalized in Gyeongsangbuk-do. Methods Three hundred and fifty-two patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection hospitalized at Dongguk University Gyeongju Hospital or at the Andong Medical Center between February 18th and June 30th were enrolled in this study. Medical records were reviewed and demographic and clinical features, including comorbidities, symptoms, radiological and laboratory findings on admission were analyzed. In addition, we sought to identify risk factors of mortality. Results Mean age of the 352 study subjects was 56 years (range, 14–95). The mortality rate was 6.8% and mean age at death was 81 years (range, 57–91). The most common symptom was cough (31.8%) followed by a febrile sensation (28.4%), sputum (17.0%), sore throat (15.6%), and myalgia (13.1%). Eighty-one (23.0%) patients were asymptomatic, but a half of these patients exhibited pneumonic infiltration at presentation. Chest radiology showed no active lesion in 41.8% of the study subjects, bilateral pneumonia in 46.9%, and unilateral pneumonic infiltration in 11.4%. Among 24 patients that died, 18 subjects were transferred from a care facility. An age of ≥ 70 years, previous history of malignancy or diabetes, and fever (≥ 37.5°C) on admission were found to be significant risk factors of mortality. Conclusion Patients aged ≥ 70 years, those with fever on admission, and patients with an underlying malignancy or diabetes were found to be more likely to succumb to COVID-19. Elderly in care facilities or hospitalized patients with an underlying disease should receive more attention and be considered for preventive quarantine.

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“…These two university hospitals are the largest among the four designated explicitly for patients with severe COVID-19 transferred from other facilities or hospitals in Daegu. The diagnosis of COVID-19 was made with positive results by real-time reverse transcription polymerase chain reaction assay for SARS-CoV-2 in upper respiratory specimens (nasopharyngeal and oropharyngeal swab), with or without a lower respiratory specimen (sputum) [12]. Based on clinical judgments, patients who were transferred because their medical conditions required prompt intensive monitoring and care in the early stages of the outbreak were investigated.…”

Section: Study Design and Participantsmentioning

confidence: 99%

Fasting Plasma Glucose Level Independently Predicts the Mortality of Patients with Coronavirus Disease 2019 Infection: A Multicenter, Retrospective Cohort Study

Lee¹,

Hwang²,

Jeon

et al. 2020

Endocrinol Metab

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Background: Coronavirus disease 2019 (COVID-19) has become a global pandemic, which prompts a consensus for the necessity to seek risk factors for this critical disease. Risk factors affecting mortality of the disease remain elusive. Diabetes and hyperglycemia are known to negatively affect a host's antiviral immunity. We evaluated the relationship between a history of diabetes, fasting plasma glucose (FPG) levels and mortality among severely ill patients with COVID-19. Methods: This was a retrospective cohort study that assessed 106 adult inpatients (aged ≥18 years) from two tertiary hospitals in Daegu, South Korea. The participants were transferred to tertiary hospitals because their medical condition required immediate intensive care. The demographic and laboratory data were compared between COVID-19 patients who survived and those who did not. Results: Compared with the survivor group, age, and the proportions of diabetes, chronic lung disease and FPG were significantly higher in the deceased group. In the Cox proportional hazards regression model for survival analysis, FPG level and age were identified as significant predictors of mortality (P<0.05). The threshold values for predicting high mortality were age >68 years and FPG of 168 mg/dL, respectively. Among those without diabetes, high FPG remained a significant predictor of mortality (P<0.04). Conclusion: High FPG levels significantly predicted mortality in COVID-19, regardless of a known history of diabetes. These results suggest intensive monitoring should be provided to COVID-19 patients who have a high FPG level.

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The Risk of Diabetes on Clinical Outcomes in Patients with Coronavirus Disease 2019: A Retrospective Cohort Study

Cited by 62 publications

References 26 publications

Mortality Rate and Predictors of Mortality in Hospitalized COVID-19 Patients with Diabetes

Mortality Rate and Predictors of Mortality in Hospitalized COVID-19 Patients with Diabetes

Clinical Characteristics and Mortality Predictors of COVID-19 Patients Hospitalized at Nationally-Designated Treatment Hospitals

Fasting Plasma Glucose Level Independently Predicts the Mortality of Patients with Coronavirus Disease 2019 Infection: A Multicenter, Retrospective Cohort Study

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