Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort study
Abstract Background Limited evidence exists on the role of glucose-lowering drugs in patients with COVID-19. Our main objective was to examine the association between in-hospital death and each routine at-home glucose-lowering drug both individually and in combination with metformin in patients with...
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| Format: | Article |
| Language: | English |
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BMC
2020-11-01
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| Series: | BMC Medicine |
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| Online Access: | http://link.springer.com/article/10.1186/s12916-020-01832-2 |
| _version_ | 1818436606099456000 |
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| author | Luis M. Pérez-Belmonte José David Torres-Peña María D. López-Carmona M. Mar. Ayala-Gutiérrez Francisco Fuentes-Jiménez Lucía Jorge Huerta Jaime Alonso Muñoz Manuel Rubio-Rivas Manel Madrazo Marcos Guzmán Garcia Beatriz Vicente Montes Joaquim Fernández Sola Javier Ena Ruth Gonzalez Ferrer Carmen Mella Pérez Carlos Jorge Ripper Jose Javier Napal Lecumberri Iris El Attar Acedo Susana Plaza Canteli Sara Fuente Cosío Francisco Amorós Martínez Begoña Cortés Rodríguez Pablo Pérez-Martínez José Manuel Ramos-Rincón Ricardo Gómez-Huelgas for the SEMI-COVID-19 Network |
| author_facet | Luis M. Pérez-Belmonte José David Torres-Peña María D. López-Carmona M. Mar. Ayala-Gutiérrez Francisco Fuentes-Jiménez Lucía Jorge Huerta Jaime Alonso Muñoz Manuel Rubio-Rivas Manel Madrazo Marcos Guzmán Garcia Beatriz Vicente Montes Joaquim Fernández Sola Javier Ena Ruth Gonzalez Ferrer Carmen Mella Pérez Carlos Jorge Ripper Jose Javier Napal Lecumberri Iris El Attar Acedo Susana Plaza Canteli Sara Fuente Cosío Francisco Amorós Martínez Begoña Cortés Rodríguez Pablo Pérez-Martínez José Manuel Ramos-Rincón Ricardo Gómez-Huelgas for the SEMI-COVID-19 Network |
| author_sort | Luis M. Pérez-Belmonte |
| collection | DOAJ |
| description | Abstract Background Limited evidence exists on the role of glucose-lowering drugs in patients with COVID-19. Our main objective was to examine the association between in-hospital death and each routine at-home glucose-lowering drug both individually and in combination with metformin in patients with type 2 diabetes mellitus admitted for COVID-19. We also evaluated their association with the composite outcome of the need for ICU admission, invasive and non-invasive mechanical ventilation, or in-hospital death as well as on the development of in-hospital complications and a long-time hospital stay. Methods We selected all patients with type 2 diabetes mellitus in the Spanish Society of Internal Medicine’s registry of COVID-19 patients (SEMI-COVID-19 Registry). It is an ongoing, observational, multicenter, nationwide cohort of patients admitted for COVID-19 in Spain from March 1, 2020. Each glucose-lowering drug user was matched with a user of other glucose-lowering drugs in a 1:1 manner by propensity scores. In order to assess the adequacy of propensity score matching, we used the standardized mean difference found in patient characteristics after matching. There was considered to be a significant imbalance in the group if a standardized mean difference > 10% was found. To evaluate the association between treatment and study outcomes, both conditional logit and mixed effect logistic regressions were used when the sample size was ≥ 100. Results A total of 2666 patients were found in the SEMI-COVID-19 Registry, 1297 on glucose-lowering drugs in monotherapy and 465 in combination with metformin. After propensity matching, 249 patients on metformin, 105 on dipeptidyl peptidase-4 inhibitors, 129 on insulin, 127 on metformin/dipeptidyl peptidase-4 inhibitors, 34 on metformin/sodium-glucose cotransporter 2 inhibitor, and 67 on metformin/insulin were selected. No at-home glucose-lowering drugs showed a significant association with in-hospital death; the composite outcome of the need of intensive care unit admission, mechanical ventilation, or in-hospital death; in-hospital complications; or long-time hospital stays. Conclusions In patients with type 2 diabetes mellitus admitted for COVID-19, at-home glucose-lowering drugs showed no significant association with mortality and adverse outcomes. Given the close relationship between diabetes and COVID-19 and the limited evidence on the role of glucose-lowering drugs, prospective studies are needed. |
| first_indexed | 2024-12-14T17:11:27Z |
| format | Article |
| id | doaj.art-075d60a7a4074e35b070c9194fc6a79a |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-12-14T17:11:27Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-075d60a7a4074e35b070c9194fc6a79a2022-12-21T22:53:32ZengBMCBMC Medicine1741-70152020-11-0118111010.1186/s12916-020-01832-2Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort studyLuis M. Pérez-Belmonte0José David Torres-Peña1María D. López-Carmona2M. Mar. Ayala-Gutiérrez3Francisco Fuentes-Jiménez4Lucía Jorge Huerta5Jaime Alonso Muñoz6Manuel Rubio-Rivas7Manel Madrazo8Marcos Guzmán Garcia9Beatriz Vicente Montes10Joaquim Fernández Sola11Javier Ena12Ruth Gonzalez Ferrer13Carmen Mella Pérez14Carlos Jorge Ripper15Jose Javier Napal Lecumberri16Iris El Attar Acedo17Susana Plaza Canteli18Sara Fuente Cosío19Francisco Amorós Martínez20Begoña Cortés Rodríguez21Pablo Pérez-Martínez22José Manuel Ramos-Rincón23Ricardo Gómez-Huelgas24for the SEMI-COVID-19 NetworkInternal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA)Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of CordobaInternal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA)Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA)Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of CordobaInternal Medicine Department, 12 de Octubre University HospitalInternal Medicine Department, Gregorio Marañon University HospitalInternal Medicine Department, Bellvitge University HospitalInternal Medicine Department, Dr. Peset University HospitalInternal Medicine Department, San Juan de la Cruz HospitalInternal Medicine Department, León University Hospital ComplexInternal Medicine Department, Clinic Barcelona HospitalInternal Medicine Department, Marina Baixa HospitalInternal Medicine Department, Tajo HospitalInternal Medicine Department, Ferrol University Hospital ComplexInternal Medicine Department, Insular de Gran Canaria HospitalInternal Medicine Department, Marqués de Valdecilla University HospitalInternal Medicine Department, Torrecárdenas HospitalInternal Medicine Department, Severo Ochoa University HospitalInternal Medicine Department, Valle del Nalón HospitalInternal Medicine Department, Vinalopó University HospitalInternal Medicine Department, Alto Guadalquivir HospitalLipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of CordobaDepartment of Clinical Medicine, Miguel Hernandez University of ElcheInternal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA)Abstract Background Limited evidence exists on the role of glucose-lowering drugs in patients with COVID-19. Our main objective was to examine the association between in-hospital death and each routine at-home glucose-lowering drug both individually and in combination with metformin in patients with type 2 diabetes mellitus admitted for COVID-19. We also evaluated their association with the composite outcome of the need for ICU admission, invasive and non-invasive mechanical ventilation, or in-hospital death as well as on the development of in-hospital complications and a long-time hospital stay. Methods We selected all patients with type 2 diabetes mellitus in the Spanish Society of Internal Medicine’s registry of COVID-19 patients (SEMI-COVID-19 Registry). It is an ongoing, observational, multicenter, nationwide cohort of patients admitted for COVID-19 in Spain from March 1, 2020. Each glucose-lowering drug user was matched with a user of other glucose-lowering drugs in a 1:1 manner by propensity scores. In order to assess the adequacy of propensity score matching, we used the standardized mean difference found in patient characteristics after matching. There was considered to be a significant imbalance in the group if a standardized mean difference > 10% was found. To evaluate the association between treatment and study outcomes, both conditional logit and mixed effect logistic regressions were used when the sample size was ≥ 100. Results A total of 2666 patients were found in the SEMI-COVID-19 Registry, 1297 on glucose-lowering drugs in monotherapy and 465 in combination with metformin. After propensity matching, 249 patients on metformin, 105 on dipeptidyl peptidase-4 inhibitors, 129 on insulin, 127 on metformin/dipeptidyl peptidase-4 inhibitors, 34 on metformin/sodium-glucose cotransporter 2 inhibitor, and 67 on metformin/insulin were selected. No at-home glucose-lowering drugs showed a significant association with in-hospital death; the composite outcome of the need of intensive care unit admission, mechanical ventilation, or in-hospital death; in-hospital complications; or long-time hospital stays. Conclusions In patients with type 2 diabetes mellitus admitted for COVID-19, at-home glucose-lowering drugs showed no significant association with mortality and adverse outcomes. Given the close relationship between diabetes and COVID-19 and the limited evidence on the role of glucose-lowering drugs, prospective studies are needed.http://link.springer.com/article/10.1186/s12916-020-01832-2Type 2 diabetes mellitusGlucose-lowering drugCoronavirus disease 2019 |
| spellingShingle | Luis M. Pérez-Belmonte José David Torres-Peña María D. López-Carmona M. Mar. Ayala-Gutiérrez Francisco Fuentes-Jiménez Lucía Jorge Huerta Jaime Alonso Muñoz Manuel Rubio-Rivas Manel Madrazo Marcos Guzmán Garcia Beatriz Vicente Montes Joaquim Fernández Sola Javier Ena Ruth Gonzalez Ferrer Carmen Mella Pérez Carlos Jorge Ripper Jose Javier Napal Lecumberri Iris El Attar Acedo Susana Plaza Canteli Sara Fuente Cosío Francisco Amorós Martínez Begoña Cortés Rodríguez Pablo Pérez-Martínez José Manuel Ramos-Rincón Ricardo Gómez-Huelgas for the SEMI-COVID-19 Network Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort study BMC Medicine Type 2 diabetes mellitus Glucose-lowering drug Coronavirus disease 2019 |
| title | Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort study |
| title_full | Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort study |
| title_fullStr | Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort study |
| title_full_unstemmed | Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort study |
| title_short | Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort study |
| title_sort | mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for covid 19 in association with glucose lowering drugs a nationwide cohort study |
| topic | Type 2 diabetes mellitus Glucose-lowering drug Coronavirus disease 2019 |
| url | http://link.springer.com/article/10.1186/s12916-020-01832-2 |
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