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Clinical Characteristics and Risk Factors for Mortality of COVID-19 Patients With Diabetes in Wuhan, China: A Two-Center, Retrospective Study

Diabetes care, 2020-07, Vol.43 (7), p.1382-1391 [Peer Reviewed Journal]

2020 by the American Diabetes Association. ;Copyright American Diabetes Association Jul 1, 2020 ;ISSN: 0149-5992 ;EISSN: 1935-5548 ;DOI: 10.2337/dc20-0598 ;PMID: 32409504

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Title:
Clinical Characteristics and Risk Factors for Mortality of COVID-19 Patients With Diabetes in Wuhan, China: A Two-Center, Retrospective Study
Author: Shi, Qiao ; Zhang, Xiaoyi ; Jiang, Fang ; Zhang, Xuanzhe ; Hu, Ning ; Bimu, Chibu ; Feng, Jiarui ; Yan, Su ; Guan, Yongjun ; Xu, Dongxue ; He, Guangzhen ; Chen, Chen ; Xiong, Xingcheng ; Liu, Lei ; Li, Hanjun ; Tao, Jing ; Peng, Zhiyong ; Wang, Weixing
Subjects: Age ; Aged ; Betacoronavirus ; Cardiovascular disease ; Cardiovascular diseases ; Comorbidity ; Coronavirus Infections - mortality ; Coronavirus Infections - physiopathology ; Coronaviruses ; COVID-19 ; Death ; Diabetes ; Diabetes mellitus ; Diabetes Mellitus, Type 2 - mortality ; Diabetes Mellitus, Type 2 - physiopathology ; Fatalities ; Female ; Hazard identification ; Health hazards ; Hospital Mortality ; Hospitalization ; Humans ; Hypertension ; Hypertension - mortality ; Lung diseases ; Male ; Middle Aged ; Mortality ; Pandemics ; Patients ; Pneumonia, Viral - mortality ; Pneumonia, Viral - physiopathology ; Proportional Hazards Models ; Regression analysis ; Research design ; Retrospective Studies ; Risk analysis ; Risk Factors ; SARS-CoV-2 ; Sex
Is Part Of: Diabetes care, 2020-07, Vol.43 (7), p.1382-1391
Description: Diabetes is common in COVID-19 patients and associated with unfavorable outcomes. We aimed to describe the characteristics and outcomes and to analyze the risk factors for in-hospital mortality of COVID-19 patients with diabetes. This two-center retrospective study was performed at two tertiary hospitals in Wuhan, China. Confirmed COVID-19 patients with diabetes ( = 153) who were discharged or died from 1 January 2020 to 8 March 2020 were identified. One sex- and age-matched COVID-19 patient without diabetes was randomly selected for each patient with diabetes. Demographic, clinical, and laboratory data were abstracted. Cox proportional hazards regression analyses were performed to identify the risk factors associated with the mortality in these patients. Of 1,561 COVID-19 patients, 153 (9.8%) had diabetes, with a median age of 64.0 (interquartile range 56.0-72.0) years. A higher proportion of intensive care unit admission (17.6% vs. 7.8%, = 0.01) and more fatal cases (20.3% vs. 10.5%, = 0.017) were identified in COVID-19 patients with diabetes than in the matched patients. Multivariable Cox regression analyses of these 306 patients showed that hypertension (hazard ratio [HR] 2.50, 95% CI 1.30-4.78), cardiovascular disease (HR 2.24, 95% CI 1.19-4.23), and chronic pulmonary disease (HR 2.51, 95% CI 1.07-5.90) were independently associated with in-hospital death. Diabetes (HR 1.58, 95% CI 0.84-2.99) was not statistically significantly associated with in-hospital death after adjustment. Among patients with diabetes, nonsurvivors were older (76.0 vs. 63.0 years), most were male (71.0% vs. 29.0%), and they were more likely to have underlying hypertension (83.9% vs. 50.0%) and cardiovascular disease (45.2% vs. 14.8%) (all values <0.05). Age ≥70 years (HR 2.39, 95% CI 1.03-5.56) and hypertension (HR 3.10, 95% CI 1.14-8.44) were independent risk factors for in-hospital death of patients with diabetes. COVID-19 patients with diabetes had worse outcomes compared with the sex- and age-matched patients without diabetes. Older age and comorbid hypertension independently contributed to in-hospital death of patients with diabetes.
Publisher: United States: American Diabetes Association
Language: English
Identifier: ISSN: 0149-5992
EISSN: 1935-5548
DOI: 10.2337/dc20-0598
PMID: 32409504
Source: Geneva Foundation Free Medical Journals at publisher websites
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Clinical Characteristics and Risk Factors for Mortality of COVID-19 Patients With Diabetes in Wuhan, China: A Two-Center, Retrospective Study

2020 by the American Diabetes Association. ;Copyright American Diabetes Association Jul 1, 2020 ;ISSN: 0149-5992 ;EISSN: 1935-5548 ;DOI: 10.2337/dc20-0598 ;PMID: 32409504

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