The clinical profile and associated mortality in people with and without diabetes with Coronavirus disease 2019 on admission to acute hospital services
Abstract Introduction To assess if in adults with COVID‐19, whether those with diabetes and complications (DM+C) present with a more severe clinical profile and if that relates to increased mortality, compared to those with diabetes with no complications (DM‐NC) and those without diabetes. Methods S...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Endocrinology, Diabetes & Metabolism |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/edm2.309 |
| _version_ | 1798021098830299136 |
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| author | Krishna Gokhale Samiul A. Mostafa Jingya Wang Abd A. Tahrani Christopher Andrew Sainsbury Konstantinos A. Toulis G. Neil Thomas Zaki Hassan‐Smith Elizabeth Sapey Suzy Gallier Nicola Jaime Adderley Parth Narendran Srikanth Bellary Tom Taverner Sandip Ghosh Krishnarajah Nirantharakumar Wasim Hanif |
| author_facet | Krishna Gokhale Samiul A. Mostafa Jingya Wang Abd A. Tahrani Christopher Andrew Sainsbury Konstantinos A. Toulis G. Neil Thomas Zaki Hassan‐Smith Elizabeth Sapey Suzy Gallier Nicola Jaime Adderley Parth Narendran Srikanth Bellary Tom Taverner Sandip Ghosh Krishnarajah Nirantharakumar Wasim Hanif |
| author_sort | Krishna Gokhale |
| collection | DOAJ |
| description | Abstract Introduction To assess if in adults with COVID‐19, whether those with diabetes and complications (DM+C) present with a more severe clinical profile and if that relates to increased mortality, compared to those with diabetes with no complications (DM‐NC) and those without diabetes. Methods Service‐level data was used from 996 adults with laboratory confirmed COVID‐19 who presented to the Queen Elizabeth Hospital Birmingham, UK, from March to June 2020. All individuals were categorized into DM+C, DM‐NC, and non‐diabetes groups. Physiological and laboratory measurements in the first 5 days after admission were collated and compared among groups. Cox proportional hazards regression models were used to evaluate associations between diabetes status and the risk of mortality. Results Among the 996 individuals, 104 (10.4%) were DM+C, 295 (29.6%) DM‐NC and 597 (59.9%) non‐diabetes. There were 309 (31.0%) in‐hospital deaths documented, 40 (4.0% of total cohort) were DM+C, 99 (9.9%) DM‐NC and 170 (17.0%) non‐diabetes. Individuals with DM+C were more likely to present with high anion gap/metabolic acidosis, features of renal impairment, and low albumin/lymphocyte count than those with DM‐NC or those without diabetes. There was no significant difference in mortality rates among the groups: compared to individuals without diabetes, the adjusted HRs were 1.39 (95% CI 0.95–2.03, p = 0.093) and 1.18 (95% CI 0.90–1.54, p = 0.226) in DM+C and DM‐C, respectively. Conclusions Those with COVID‐19 and DM+C presented with a more severe clinical and biochemical profile, but this did not associate with increased mortality in this study. |
| first_indexed | 2024-04-11T17:08:32Z |
| format | Article |
| id | doaj.art-ccb37b634740430689c1e456099f1157 |
| institution | Directory Open Access Journal |
| issn | 2398-9238 |
| language | English |
| last_indexed | 2024-04-11T17:08:32Z |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Endocrinology, Diabetes & Metabolism |
| spelling | doaj.art-ccb37b634740430689c1e456099f11572022-12-22T04:12:58ZengWileyEndocrinology, Diabetes & Metabolism2398-92382022-01-0151n/an/a10.1002/edm2.309The clinical profile and associated mortality in people with and without diabetes with Coronavirus disease 2019 on admission to acute hospital servicesKrishna Gokhale0Samiul A. Mostafa1Jingya Wang2Abd A. Tahrani3Christopher Andrew Sainsbury4Konstantinos A. Toulis5G. Neil Thomas6Zaki Hassan‐Smith7Elizabeth Sapey8Suzy Gallier9Nicola Jaime Adderley10Parth Narendran11Srikanth Bellary12Tom Taverner13Sandip Ghosh14Krishnarajah Nirantharakumar15Wasim Hanif16Institute of Applied Health Research University of Birmingham Birmingham UKDepartment of Diabetes Medicine University Hospitals of Birmingham Birmingham UKInstitute of Applied Health Research University of Birmingham Birmingham UKInstitute of Metabolism and Systems Research University of Birmingham Birmingham UKInstitute of Applied Health Research University of Birmingham Birmingham UKInstitute of Applied Health Research University of Birmingham Birmingham UKInstitute of Applied Health Research University of Birmingham Birmingham UKInstitute of Metabolism and Systems Research University of Birmingham Birmingham UKInstitute of Applied Health Research University of Birmingham Birmingham UKMidlands Health Data Research UK Birmingham UKInstitute of Applied Health Research University of Birmingham Birmingham UKInstitute of Metabolism and Systems Research University of Birmingham Birmingham UKDepartment of Diabetes and Endocrinology University Hospitals Birmingham NHSFoundation Trust Birmingham UKInstitute of Applied Health Research University of Birmingham Birmingham UKDepartment of Diabetes Medicine University Hospitals of Birmingham Birmingham UKInstitute of Applied Health Research University of Birmingham Birmingham UKDepartment of Diabetes Medicine University Hospitals of Birmingham Birmingham UKAbstract Introduction To assess if in adults with COVID‐19, whether those with diabetes and complications (DM+C) present with a more severe clinical profile and if that relates to increased mortality, compared to those with diabetes with no complications (DM‐NC) and those without diabetes. Methods Service‐level data was used from 996 adults with laboratory confirmed COVID‐19 who presented to the Queen Elizabeth Hospital Birmingham, UK, from March to June 2020. All individuals were categorized into DM+C, DM‐NC, and non‐diabetes groups. Physiological and laboratory measurements in the first 5 days after admission were collated and compared among groups. Cox proportional hazards regression models were used to evaluate associations between diabetes status and the risk of mortality. Results Among the 996 individuals, 104 (10.4%) were DM+C, 295 (29.6%) DM‐NC and 597 (59.9%) non‐diabetes. There were 309 (31.0%) in‐hospital deaths documented, 40 (4.0% of total cohort) were DM+C, 99 (9.9%) DM‐NC and 170 (17.0%) non‐diabetes. Individuals with DM+C were more likely to present with high anion gap/metabolic acidosis, features of renal impairment, and low albumin/lymphocyte count than those with DM‐NC or those without diabetes. There was no significant difference in mortality rates among the groups: compared to individuals without diabetes, the adjusted HRs were 1.39 (95% CI 0.95–2.03, p = 0.093) and 1.18 (95% CI 0.90–1.54, p = 0.226) in DM+C and DM‐C, respectively. Conclusions Those with COVID‐19 and DM+C presented with a more severe clinical and biochemical profile, but this did not associate with increased mortality in this study.https://doi.org/10.1002/edm2.309complicationsCOVID‐19diabetes |
| spellingShingle | Krishna Gokhale Samiul A. Mostafa Jingya Wang Abd A. Tahrani Christopher Andrew Sainsbury Konstantinos A. Toulis G. Neil Thomas Zaki Hassan‐Smith Elizabeth Sapey Suzy Gallier Nicola Jaime Adderley Parth Narendran Srikanth Bellary Tom Taverner Sandip Ghosh Krishnarajah Nirantharakumar Wasim Hanif The clinical profile and associated mortality in people with and without diabetes with Coronavirus disease 2019 on admission to acute hospital services Endocrinology, Diabetes & Metabolism complications COVID‐19 diabetes |
| title | The clinical profile and associated mortality in people with and without diabetes with Coronavirus disease 2019 on admission to acute hospital services |
| title_full | The clinical profile and associated mortality in people with and without diabetes with Coronavirus disease 2019 on admission to acute hospital services |
| title_fullStr | The clinical profile and associated mortality in people with and without diabetes with Coronavirus disease 2019 on admission to acute hospital services |
| title_full_unstemmed | The clinical profile and associated mortality in people with and without diabetes with Coronavirus disease 2019 on admission to acute hospital services |
| title_short | The clinical profile and associated mortality in people with and without diabetes with Coronavirus disease 2019 on admission to acute hospital services |
| title_sort | clinical profile and associated mortality in people with and without diabetes with coronavirus disease 2019 on admission to acute hospital services |
| topic | complications COVID‐19 diabetes |
| url | https://doi.org/10.1002/edm2.309 |
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