tetano
Editor, Senior Moderator
Diabetes Obes Metab
. 2022 Aug 20.
doi: 10.1111/dom.14845. Online ahead of print.
Associations of microvascular complications with all-cause death in patients with diabetes and COVID-19: the CORONADO, ABCD Covid-19 audit and AMERICADO study groups
Samy Hadjadj[SUP] #[/SUP][SUP] 1 [/SUP], Pierre-Jean Saulnier[SUP] #[/SUP][SUP] 2 [/SUP], Yue Ruan[SUP] #[/SUP][SUP] 3 4 [/SUP], Xu Zhu[SUP] #[/SUP][SUP] 5 [/SUP], Renee Pekmezaris[SUP] 5 [/SUP], Michel Marre[SUP] 6 [/SUP], Jean Michel Halimi[SUP] 7 [/SUP], Matthieu Wargny[SUP] 1 8 [/SUP], Rustam Rea[SUP] #[/SUP][SUP] 3 4 [/SUP], Pierre Gourdy[SUP] #[/SUP][SUP] 9 [/SUP], Bertrand Cariou[SUP] #[/SUP][SUP] 1 [/SUP], Alyson Myers[SUP] #[/SUP][SUP] 10 [/SUP], Kamlesh Khunti[SUP] #[/SUP][SUP] 11 [/SUP], CORONADO, the ABCD COVID-19 diabetes national audit and AMERICADO investigators
Collaborators, Affiliations
Abstract
Aim: The prognostic role of microvascular complications for all-cause death in patients with diabetes hospitalized for coronavirus disease-2019 (COVID-19) has been suggested. However, no detailed analysis of the microvascular burden in these patients is available so far.
Materials and methods: We analysed data from the French CORONADO initiative and the United Kingdom ABCD Covid-19 audit, two nationwide multicenter studies, and the AMERICADO, a multicenter study in New York area. We assessed the association between the risk of all-cause death during hospital stay and microvascular complications, in patients with diabetes hospitalized for COVID-19: diabetic retinopathy and/or diabetic kidney disease and/or history of diabetic foot ulcer.
Results: Among 2951 CORONADO, 3387 ABCD COVID-19 audit and 9327 AMERICADO participants, the status for microvascular diabetic complications was ascertained for 1314 (44.5%), 1809 (53.4%) and 7367 (79.0%) patients: 1010, 1059 and 1800 with ≥1 severe microvascular complication(s) and 304, 750 and 5567 participants free of any complications, respectively. The patients with isolated DKD had an increased risk for all-cause death during hospital stay: OR: 2.53 (95% CI: 1.66-3.83), OR: 1.24 (95% CI: 1.00-1.56) and OR: 1.66 (95% CI: 1.40-1.95), in the CORONADO, the ABCD-COVID-19 national Audit and the AMERICADO studies, respectively. After adjustment for age, sex, hypertension and cardiovascular disease (CVD), compared to those without microvascular complications, patients with microvascular complications had an increased risk of all-cause death during hospital stay in the CORONADO, the ABCD COVID-19 diabetes national audit and the AMERICADO participants: [SUB]adj[/SUB] OR: 2.57 (1.69-3.92), [SUB]adj[/SUB] OR: 1.22 (1.00-1.52) and [SUB]adj[/SUB] OR: 1.33 (1.15-1.53), respectively. When meta-analysing the 3 studies, compared to those patients free of complication, those with microvascular complications had an unadjusted OR for all-cause death during hospital stay of 2.05 (1.42-2.97) which decreased to 1.62 (1.19-2.119) after adjustment for age, sex and to 1.50 (1.12-2.02) after hypertension and CVD were further added to the model.
Conclusion: Microvascular burden is associated with an increased risk of death in patients hospitalized for COVID-19. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; chronic kidney disease; diabetic foot; microvascular complications; mortality; retinopathy.
. 2022 Aug 20.
doi: 10.1111/dom.14845. Online ahead of print.
Associations of microvascular complications with all-cause death in patients with diabetes and COVID-19: the CORONADO, ABCD Covid-19 audit and AMERICADO study groups
Samy Hadjadj[SUP] #[/SUP][SUP] 1 [/SUP], Pierre-Jean Saulnier[SUP] #[/SUP][SUP] 2 [/SUP], Yue Ruan[SUP] #[/SUP][SUP] 3 4 [/SUP], Xu Zhu[SUP] #[/SUP][SUP] 5 [/SUP], Renee Pekmezaris[SUP] 5 [/SUP], Michel Marre[SUP] 6 [/SUP], Jean Michel Halimi[SUP] 7 [/SUP], Matthieu Wargny[SUP] 1 8 [/SUP], Rustam Rea[SUP] #[/SUP][SUP] 3 4 [/SUP], Pierre Gourdy[SUP] #[/SUP][SUP] 9 [/SUP], Bertrand Cariou[SUP] #[/SUP][SUP] 1 [/SUP], Alyson Myers[SUP] #[/SUP][SUP] 10 [/SUP], Kamlesh Khunti[SUP] #[/SUP][SUP] 11 [/SUP], CORONADO, the ABCD COVID-19 diabetes national audit and AMERICADO investigators
Collaborators, Affiliations
- PMID: 36053971
- DOI: 10.1111/dom.14845
Abstract
Aim: The prognostic role of microvascular complications for all-cause death in patients with diabetes hospitalized for coronavirus disease-2019 (COVID-19) has been suggested. However, no detailed analysis of the microvascular burden in these patients is available so far.
Materials and methods: We analysed data from the French CORONADO initiative and the United Kingdom ABCD Covid-19 audit, two nationwide multicenter studies, and the AMERICADO, a multicenter study in New York area. We assessed the association between the risk of all-cause death during hospital stay and microvascular complications, in patients with diabetes hospitalized for COVID-19: diabetic retinopathy and/or diabetic kidney disease and/or history of diabetic foot ulcer.
Results: Among 2951 CORONADO, 3387 ABCD COVID-19 audit and 9327 AMERICADO participants, the status for microvascular diabetic complications was ascertained for 1314 (44.5%), 1809 (53.4%) and 7367 (79.0%) patients: 1010, 1059 and 1800 with ≥1 severe microvascular complication(s) and 304, 750 and 5567 participants free of any complications, respectively. The patients with isolated DKD had an increased risk for all-cause death during hospital stay: OR: 2.53 (95% CI: 1.66-3.83), OR: 1.24 (95% CI: 1.00-1.56) and OR: 1.66 (95% CI: 1.40-1.95), in the CORONADO, the ABCD-COVID-19 national Audit and the AMERICADO studies, respectively. After adjustment for age, sex, hypertension and cardiovascular disease (CVD), compared to those without microvascular complications, patients with microvascular complications had an increased risk of all-cause death during hospital stay in the CORONADO, the ABCD COVID-19 diabetes national audit and the AMERICADO participants: [SUB]adj[/SUB] OR: 2.57 (1.69-3.92), [SUB]adj[/SUB] OR: 1.22 (1.00-1.52) and [SUB]adj[/SUB] OR: 1.33 (1.15-1.53), respectively. When meta-analysing the 3 studies, compared to those patients free of complication, those with microvascular complications had an unadjusted OR for all-cause death during hospital stay of 2.05 (1.42-2.97) which decreased to 1.62 (1.19-2.119) after adjustment for age, sex and to 1.50 (1.12-2.02) after hypertension and CVD were further added to the model.
Conclusion: Microvascular burden is associated with an increased risk of death in patients hospitalized for COVID-19. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; chronic kidney disease; diabetic foot; microvascular complications; mortality; retinopathy.