Association between hyperglycemia treatment and mortality in patients with diabetes and COVID-19 in a Peruvian hospital: A retrospective cohort study
Objective: To evaluate the association between hyperglycemia treatment and mortality in patients with diabetes and COVID-19 in a Peruvian hospital. Methods: A retrospective cohort study was conducted between March and July 2020. Individual-level data were extracted from an implemented virtual platfo...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-12-01
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| Series: | Journal of Clinical & Translational Endocrinology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S221462372100017X |
| _version_ | 1818461981471932416 |
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| author | Eddy Lopez-Huamanrayme Dioni D. Garate-Chirinos Frank Espinoza-Morales Sharon Del-Castillo-Ochoa Andrés Gomez-Noronha Elizabeth Salsavilca-Macavilca Alvaro Taype-Rondan Francisco J. Pasquel |
| author_facet | Eddy Lopez-Huamanrayme Dioni D. Garate-Chirinos Frank Espinoza-Morales Sharon Del-Castillo-Ochoa Andrés Gomez-Noronha Elizabeth Salsavilca-Macavilca Alvaro Taype-Rondan Francisco J. Pasquel |
| author_sort | Eddy Lopez-Huamanrayme |
| collection | DOAJ |
| description | Objective: To evaluate the association between hyperglycemia treatment and mortality in patients with diabetes and COVID-19 in a Peruvian hospital. Methods: A retrospective cohort study was conducted between March and July 2020. Individual-level data were extracted from an implemented virtual platform. We included patients with type 2 diabetes hospitalized with COVID-19. The assessed outcome was in-hospital mortality. The Independent variable of interest was hyperglycemic treatment. We used Poisson regressions with robust variance to obtain crude and adjusted relative risks (RR) and their 95% confidence intervals (95% CI). Results: Out of 1635 patients hospitalized for COVID-19 during the study period, 248 patients with diabetes mellitus were included. The majority were men (66.9%), the median age was 62 years. Ninety-seven patients died in the hospital (39.1%). The median glycemia on admission was 222.5 mg/dL. At 48 h after hospital admission, 125 patients (50.4%) received sliding scale insulin alone (SSI), 46 (18.5%) received a fixed-dose insulin regimen. In the adjusted analysis, the group with SSI at 48 h of hospitalization had higher mortality than those with fixed-dose insulin (adjusted RR: 1.69; 95% CI: 1.01 – 2.83), and those and who continued with SSI in the following days had higher mortality compared to the group that switched to fixed-dose insulin (adjusted RR: 1.64; 95% CI: 1.17 – 2.32). Conclusion: Among assessed patients with diabetes and COVID-19, more than a third died during hospitalization. Early and continuous use of the sliding scale was associated with higher mortality compared to fixed-dose insulin regimens. |
| first_indexed | 2024-12-14T23:54:47Z |
| format | Article |
| id | doaj.art-5bf3ff461e7c42079d9808201f782c91 |
| institution | Directory Open Access Journal |
| issn | 2214-6237 |
| language | English |
| last_indexed | 2024-12-14T23:54:47Z |
| publishDate | 2021-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Clinical & Translational Endocrinology |
| spelling | doaj.art-5bf3ff461e7c42079d9808201f782c912022-12-21T22:43:09ZengElsevierJournal of Clinical & Translational Endocrinology2214-62372021-12-0126100265Association between hyperglycemia treatment and mortality in patients with diabetes and COVID-19 in a Peruvian hospital: A retrospective cohort studyEddy Lopez-Huamanrayme0Dioni D. Garate-Chirinos1Frank Espinoza-Morales2Sharon Del-Castillo-Ochoa3Andrés Gomez-Noronha4Elizabeth Salsavilca-Macavilca5Alvaro Taype-Rondan6Francisco J. Pasquel7Division of Endocrinology, Hospital Nacional Alberto Sabogal Sologuren, Lima, Peru; Corresponding author at: Division of Endocrinology, Hospital Nacional Alberto Sabogal Sologuren, 1081 Colina Jr, Bellavista 0701, Lima, Peru.Division of Endocrinology, Hospital Nacional Alberto Sabogal Sologuren, Lima, PeruCentro de Tecnologías Aplicadas a la Diabetes, Lima, PeruDivision of Endocrinology, Hospital Nacional Alberto Sabogal Sologuren, Lima, PeruDivision of Endocrinology, Hospital Nacional Alberto Sabogal Sologuren, Lima, PeruDivision of Endocrinology, Hospital Nacional Alberto Sabogal Sologuren, Lima, PeruUnidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, PeruDepartment of Medicine, Emory University School of Medicine, Atlanta, USAObjective: To evaluate the association between hyperglycemia treatment and mortality in patients with diabetes and COVID-19 in a Peruvian hospital. Methods: A retrospective cohort study was conducted between March and July 2020. Individual-level data were extracted from an implemented virtual platform. We included patients with type 2 diabetes hospitalized with COVID-19. The assessed outcome was in-hospital mortality. The Independent variable of interest was hyperglycemic treatment. We used Poisson regressions with robust variance to obtain crude and adjusted relative risks (RR) and their 95% confidence intervals (95% CI). Results: Out of 1635 patients hospitalized for COVID-19 during the study period, 248 patients with diabetes mellitus were included. The majority were men (66.9%), the median age was 62 years. Ninety-seven patients died in the hospital (39.1%). The median glycemia on admission was 222.5 mg/dL. At 48 h after hospital admission, 125 patients (50.4%) received sliding scale insulin alone (SSI), 46 (18.5%) received a fixed-dose insulin regimen. In the adjusted analysis, the group with SSI at 48 h of hospitalization had higher mortality than those with fixed-dose insulin (adjusted RR: 1.69; 95% CI: 1.01 – 2.83), and those and who continued with SSI in the following days had higher mortality compared to the group that switched to fixed-dose insulin (adjusted RR: 1.64; 95% CI: 1.17 – 2.32). Conclusion: Among assessed patients with diabetes and COVID-19, more than a third died during hospitalization. Early and continuous use of the sliding scale was associated with higher mortality compared to fixed-dose insulin regimens.http://www.sciencedirect.com/science/article/pii/S221462372100017XDiabetes mellitusCOVID-19HyperglycemiaMortalityPeruInsulin therapy |
| spellingShingle | Eddy Lopez-Huamanrayme Dioni D. Garate-Chirinos Frank Espinoza-Morales Sharon Del-Castillo-Ochoa Andrés Gomez-Noronha Elizabeth Salsavilca-Macavilca Alvaro Taype-Rondan Francisco J. Pasquel Association between hyperglycemia treatment and mortality in patients with diabetes and COVID-19 in a Peruvian hospital: A retrospective cohort study Journal of Clinical & Translational Endocrinology Diabetes mellitus COVID-19 Hyperglycemia Mortality Peru Insulin therapy |
| title | Association between hyperglycemia treatment and mortality in patients with diabetes and COVID-19 in a Peruvian hospital: A retrospective cohort study |
| title_full | Association between hyperglycemia treatment and mortality in patients with diabetes and COVID-19 in a Peruvian hospital: A retrospective cohort study |
| title_fullStr | Association between hyperglycemia treatment and mortality in patients with diabetes and COVID-19 in a Peruvian hospital: A retrospective cohort study |
| title_full_unstemmed | Association between hyperglycemia treatment and mortality in patients with diabetes and COVID-19 in a Peruvian hospital: A retrospective cohort study |
| title_short | Association between hyperglycemia treatment and mortality in patients with diabetes and COVID-19 in a Peruvian hospital: A retrospective cohort study |
| title_sort | association between hyperglycemia treatment and mortality in patients with diabetes and covid 19 in a peruvian hospital a retrospective cohort study |
| topic | Diabetes mellitus COVID-19 Hyperglycemia Mortality Peru Insulin therapy |
| url | http://www.sciencedirect.com/science/article/pii/S221462372100017X |
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