Predictors of hospital discharge and mortality in patients with diabetes and COVID-19: updated results from the nationwide CORONADO study.
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Wargny Matthieu, Potier Louis, Gourdy Pierre, Pichelin Matthieu, Amadou Coralie, Benhamou Pierre-Yves, Bonnet Jean-Baptiste, Bordier Lyse, Bourron Olivier, Chaumeil Claude, Chevalier Nicolas, Darmon Patrice, Delenne Blandine, Demarsy Delphine, Dumas Marie, Dupuy Olivier, Flaus-Furmaniuk Anna, Gautier Jean-François, Guedj Anne-Marie, Jeandidier Nathalie, Larger Etienne, Le Berre Jean-Philippe, Lungo Myriam, Montanier Nathanaëlle, Moulin Philippe, Plat Françoise, Rigalleau Vincent, Robert René, Seret-Bégué Dominique, Sérusclat Pierre, Smati Sarra, Thébaut Jean-François, Tramunt Blandine, Vatier Camille, Velayoudom Fritz-Line, Vergès Bruno, Winiszewski Patrice, Zabulon Audrey, Gourraud Pierre-Antoine, Roussel Ronan, Cariou Bertrand, Hadjadj Samy, CORONADO investigators
Аннотация
METHODS: The CORONADO initiative is a French nationwide multicentre study of patients with diabetes hospitalised for COVID-19 with a 28-day follow-up. The patients were screened after hospital admission from 10 March to 10 April 2020. We mainly focused on hospital discharge and death within 28 days.
RESULTS: We included 2796 participants: 63.7% men, mean age 69.7 ± 13.2 years, median BMI (25th-75th percentile) 28.4 (25.0-32.4) kg/m2. Microvascular and macrovascular diabetic complications were found in 44.2% and 38.6% of participants, respectively. Within 28 days, 1404 (50.2%; 95% CI 48.3%, 52.1%) were discharged from hospital with a median duration of hospital stay of 9 (5-14) days, while 577 participants died (20.6%; 95% CI 19.2%, 22.2%). In multivariable models, younger age, routine metformin therapy and longer symptom duration on admission were positively associated with discharge. History of microvascular complications, anticoagulant routine therapy, dyspnoea on admission, and higher aspartate aminotransferase, white cell count and C-reactive protein levels were associated with a reduced chance of discharge. Factors associated with death within 28 days mirrored those associated with discharge, and also included routine treatment by insulin and statin as deleterious factors.
CONCLUSIONS/INTERPRETATION: In patients with diabetes hospitalised for COVID-19, we established prognostic factors for hospital discharge and death that could help clinicians in this pandemic period.
TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT04324736.