Cardiometabolic Therapy and Mortality in Very Old Patients With Diabetes Hospitalized due to COVID-19.
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Ramos-Rincón Jose Manuel, Pérez-Belmonte Luis M, Carrasco-Sánchez Francisco Javier, Jansen-Chaparro Sergio, De-Sousa-Baena Mercedes, Bueno-Fonseca José, Pérez-Aguilar Maria, Arévalo-Cañas Coral, Bacete Cebrian Marta, Méndez-Bailón Manuel, Fiteni Mera Isabel, González García Andrés, Navarro Romero Francisco, Tuñón de Almeida Carlota, Muñiz Nicolás Gemma, González Noya Amara, Hernández Milian Almudena, García García Gema María, Alcalá Pedrajas José Nicolás, Herrero García Virginia, Corral-Gudino Luis, Comas Casanova Pere, Meijide Míguez Héctor, Casas-Rojo José Manuel, Gómez-Huelgas Ricardo, SEMI-COVID-19 Network
Аннотация
METHOD: We conducted a nationwide, multicenter, observational study in patients ≥80 years with T2DM hospitalized for COVID-19 between March 1 and May 29, 2020. The primary outcome measure was in-hospital mortality. A multivariate logistic regression analysis was performed to assess the association between preadmission cardiometabolic therapy and in-hospital mortality.
RESULTS: Of the 2 763 patients ≥80 years old hospitalized due to COVID-19, 790 (28.6%) had T2DM. Of these patients, 385 (48.7%) died during admission. On the multivariate analysis, the use of dipeptidyl peptidase-4 inhibitors (adjusted odds ratio [AOR] 0.502, 95% confidence interval [CI]: 0.309-0.815, p = .005) and angiotensin receptor blockers (AOR 0.454, 95% CI: 0.274-0.759, p = .003) were independent protectors against in-hospital mortality, whereas the use of acetylsalicylic acid was associated with higher in-hospital mortality (AOR 1.761, 95% CI: 1.092-2.842, p = .020). Other antidiabetic drugs, angiotensin-converting enzyme inhibitors, and statins showed neutral association with in-hospital mortality.
CONCLUSIONS: We found important differences between cardiometabolic drugs and in-hospital mortality in older patients with T2DM hospitalized for COVID-19. Preadmission treatment with dipeptidyl peptidase-4 inhibitors and angiotensin receptor blockers could reduce in-hospital mortality; other antidiabetic drugs, angiotensin-converting enzyme inhibitors, and statins seem to have a neutral effect; and acetylsalicylic acid could be associated with excess mortality.