tetano
Editor, Senior Moderator
BMJ Open
. 2024 Dec 4;14(12):e084087.
doi: 10.1136/bmjopen-2024-084087. Association among diabetes, cardiovascular disease and mortality in patients hospitalised for COVID-19: an analysis of the American Heart Association COVID-19 CVD Registry
Unjali Gujral[SUP] 1 [/SUP], Lauren T Vanasse[SUP] 2 [/SUP], Abhinav Goyal[SUP] 3 [/SUP], Arshed Quyyumi[SUP] 4 4 [/SUP], Colby Ayers[SUP] 5 [/SUP], Sandeep Das[SUP] 6 [/SUP], Francisco Pasquel[SUP] 7 [/SUP]
Affiliations
Objective: To examine inpatient COVID-19-related outcomes among patients with and without diabetes alone or with a history of established heart failure (HF) or established atherosclerotic cardiovascular disease (ASCVD).
Design: Observational study; longitudinal analysis of registry data.
Setting: Hospitals in the USA reporting to the American Heart Association (AHA) COVID-19 Registry from January 2020 to May 2021.
Participants: 20 796 individuals with diabetes (11 244 men; mean age 64.2) and 30 798 without diabetes (15 980 men; mean age 59.0) hospitalised for COVID-19 in the USA.
Primary and secondary outcome measures: Primary outcome measures were all-cause mortality, inpatient major adverse cardiovascular events (MACE) and/or inpatient mechanical ventilation. Secondary outcome measures included the association with diabetes and these outcomes among those with and without pre-existing ASCVD and HF and the association with insulin use and these outcomes in patients hospitalised for COVID-19.
Results: After adjustment for relevant covariates diabetes increased the risk of mortality (HR 1.12, 95% CI: 1.03 to 1.21), MACE (HR 1.32, 95% CI: 1.17 to 1.48) and mechanical ventilation (HR 1.33, 95% CI: 1.26 to 1.42). Among patients with established ASCVD or HF, diabetes did not modify the risk of adverse outcomes. There was a significant difference in the risk of mortality between patients taking insulin compared with those who were not (HR 1.32, 95% CI: 1.01 to 1.26); however, there was no difference in the risk of MACE or mechanical ventilation.
Conclusions: Diabetes was associated with a higher risk of in-hospital all-cause mortality, MACE and need for mechanical ventilation in patients hospitalised for COVID-19. Diabetes was independently associated with adverse outcomes, particularly among those without pre-existing cardiovascular disease.
Keywords: COVID-19; DIABETES & ENDOCRINOLOGY; Hospitalization; Mortality.
. 2024 Dec 4;14(12):e084087.
doi: 10.1136/bmjopen-2024-084087. Association among diabetes, cardiovascular disease and mortality in patients hospitalised for COVID-19: an analysis of the American Heart Association COVID-19 CVD Registry
Unjali Gujral[SUP] 1 [/SUP], Lauren T Vanasse[SUP] 2 [/SUP], Abhinav Goyal[SUP] 3 [/SUP], Arshed Quyyumi[SUP] 4 4 [/SUP], Colby Ayers[SUP] 5 [/SUP], Sandeep Das[SUP] 6 [/SUP], Francisco Pasquel[SUP] 7 [/SUP]
Affiliations
- PMID: 39632106
- DOI: 10.1136/bmjopen-2024-084087
Objective: To examine inpatient COVID-19-related outcomes among patients with and without diabetes alone or with a history of established heart failure (HF) or established atherosclerotic cardiovascular disease (ASCVD).
Design: Observational study; longitudinal analysis of registry data.
Setting: Hospitals in the USA reporting to the American Heart Association (AHA) COVID-19 Registry from January 2020 to May 2021.
Participants: 20 796 individuals with diabetes (11 244 men; mean age 64.2) and 30 798 without diabetes (15 980 men; mean age 59.0) hospitalised for COVID-19 in the USA.
Primary and secondary outcome measures: Primary outcome measures were all-cause mortality, inpatient major adverse cardiovascular events (MACE) and/or inpatient mechanical ventilation. Secondary outcome measures included the association with diabetes and these outcomes among those with and without pre-existing ASCVD and HF and the association with insulin use and these outcomes in patients hospitalised for COVID-19.
Results: After adjustment for relevant covariates diabetes increased the risk of mortality (HR 1.12, 95% CI: 1.03 to 1.21), MACE (HR 1.32, 95% CI: 1.17 to 1.48) and mechanical ventilation (HR 1.33, 95% CI: 1.26 to 1.42). Among patients with established ASCVD or HF, diabetes did not modify the risk of adverse outcomes. There was a significant difference in the risk of mortality between patients taking insulin compared with those who were not (HR 1.32, 95% CI: 1.01 to 1.26); however, there was no difference in the risk of MACE or mechanical ventilation.
Conclusions: Diabetes was associated with a higher risk of in-hospital all-cause mortality, MACE and need for mechanical ventilation in patients hospitalised for COVID-19. Diabetes was independently associated with adverse outcomes, particularly among those without pre-existing cardiovascular disease.
Keywords: COVID-19; DIABETES & ENDOCRINOLOGY; Hospitalization; Mortality.