According to the latest results from the Coronado study, which analyzed the outcomes of diabetic patients admitted with COVID-19, one in five patients died within 28 days and about half were discharged.The study is published at Diabetology (Journal of the European Diabetes Society [EASD]), Professors Bertland Kariu and Sammy Hajaji, diabetologists at l’institut du thorax, Nantes University Hospital, INSERM, CNRS, Nantes University in France, and colleagues.
In May 2020, preliminary results for a small sample size coronad (coronavirus SARS-CoV-2 and diabetic outcome) showed that 10% of patients Diabetes mellitus And COVID-19 died within 7 days hospital Admission.
This latest analysis included 2796 participants from 68 centers across France. Almost two-thirds (64%) were male, with an average age of 70 years and a median obesity index of 28 kg / m² (in the overweight range). Microvascular and macrovascular diabetic complications were found in 44% and 39% of participants, respectively.
Within 28 days, 1404 (50%) of patients were discharged, with a median length of stay of 9 days, but 577 participants died (21%). Of the remaining patients, 12% remained hospitalized on day 28 and 17% were transferred to a different facility than the original hospital.
Computer modeling revealed that various factors, such as youth, routine treatment of diabetes with metformin, and prolonged duration of symptoms on admission, are likely to result in discharge.
History of microvascular complications, routine anticoagulant therapy (to prevent) Blood clot), Shortness of breath on admission, abnormal levels of liver enzymes, increased white blood cell counts, and elevated levels of systemic inflammatory marker C-reactive protein are all associated with reduced likelihood of discharge and increased risk. It was. death.. Patients whose diabetes was regularly treated with insulin (which probably indicates a more advanced state of diabetes) had a 44% increased risk of death compared to patients who were not treated with insulin.
A rare finding from this study was a 42% increased risk of death in diabetics receiving high-cholesterol statin treatment. However, because this is an observational study, it is difficult to draw clear conclusions about its relationship with statins. , Or other treatments.
In this study, long-term glycemic control assessed with glycated hemoglobin (HbA1c) before or at admission did not affect the fate of COVID-19 patients and was not significantly associated with death or discharge within 28 days. I also understood that. In contrast, elevated plasma glucose levels on admission were strong predictors of mortality and consistently predicted a low likelihood of discharge.
The authors write that “identifying favorable variables associated with discharge and unfavorable variables associated with death may lead to patient reclassification and help ensure proper use of resources according to individual patient profiles.” I conclude that.
Diabetology (2021). doi.org/10.1007/s00125-020-05351-w
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