دورية أكاديمية
Adverse outcomes in COVID-19 and diabetes – a retrospective cohort study from three London Teaching hospitals
| العنوان: | Adverse outcomes in COVID-19 and diabetes – a retrospective cohort study from three London Teaching hospitals |
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| المؤلفون: | Izzi-Engbeaya, C, Distaso, W, Amin, A, Kenkre, J, Abdel-Malek, M, Hope, D, Oliver, N, Misra, S, Tan, T, Hill, N, Salem, V |
| المساهمون: | Imperial College Healthcare NHS Trust- BRC Funding, Research Trainees Coordinating Centre |
| المصدر: | 10 ; 1 |
| بيانات النشر: | BMJ Publishing Group |
| سنة النشر: | 2020 |
| المجموعة: | Imperial College London: Spiral |
| مصطلحات موضوعية: | Science & Technology, Life Sciences & Biomedicine, Endocrinology & Metabolism, type 1 diabetes mellitus, type 2 diabetes mellitus, infections, viruses, PNEUMONIA, FRAILTY, DISEASE, Adult, Age Factors, Aged, 80 and over, COVID-19, Comorbidity, Diabetes Mellitus, Female, Hospitals, Teaching, Humans, Intensive Care Units, Logistic Models, London, Male, Middle Aged, Multivariate Analysis, Retrospective Studies, Risk Factors, Sex Factors |
| الوصف: | INTRODUCTION: Patients with diabetes mellitus admitted to hospital with COVID-19 have poorer outcomes. However, the drivers for this are not fully elucidated. We performed detailed characterisation of COVID-19 patients to determine clinical and biochemical factors that may be the drivers of poorer outcomes. RESEARCH DESIGN AND METHODS: Retrospective cohort study of 889 consecutive inpatients diagnosed with COVID-19 between 9th March 2020 and 22nd April 2020 in a large London NHS Trust. Unbiased multivariate logistic regression analysis was performed to determine variables that were independently and significantly associated with increased risk of death and/or ICU admission within 30 days of COVID-19 diagnosis. RESULTS: 62% of patients in our cohort were of non-White ethnic backgrounds and the diabetes prevalence was 38%. 323 (36%) patients met the primary outcome of death/admission to the intensive care unit (ICU) within 30 days of COVID-19 diagnosis. Male gender, lower platelet count, advancing age and higher Clinical Frailty Scale (CFS) score (but not diabetes) independently predicted poor outcomes on multivariate analysis. Antiplatelet medication was associated with a lower risk of death/ICU admission. Factors that were significantly and independently associated with poorer outcomes in patients with diabetes were co-existing ischaemic heart disease, increasing age and lower platelet count. CONCLUSIONS: In this large study of a diverse patient population, comorbidity (i.e. diabetes with ischaemic heart disease; increasing CFS score in older patients) were major determinants of poor outcomes with COVID-19. Antiplatelet medication should be evaluated in randomised clinical trials amongst high-risk patient groups. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | unknown |
| تدمد: | 2052-4897 |
| العلاقة: | BMJ Open Diabetes Research and Care; http://hdl.handle.net/10044/1/84807Test; RDF01; DRF-2017-10-042 |
| DOI: | 10.1136/bmjdrc-2020-001858 |
| الإتاحة: | https://doi.org/10.1136/bmjdrc-2020-001858Test http://hdl.handle.net/10044/1/84807Test |
| حقوق: | © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0Test/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0Test/. ; https://creativecommons.org/licenses/by/4.0Test/ |
| رقم الانضمام: | edsbas.36F55EFB |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 20524897 |
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| DOI: | 10.1136/bmjdrc-2020-001858 |