Diabetes mellitus is associated with 90-day mortality in old critically ill COVID-19 patients : a multicenter prospective observational cohort study
Mayerhöfer, Timo (Medical University Innsbruck)
Klein, Sebastian (Medical University Innsbruck)
Wernly, Bernhard (Paracelsus Medical University of Salzburg)
Flaatten, Hans (Haukeland University Hospital (Noruega))
Guidet, Bertrand (Assistance Publique-Hôpitaux de Paris)
De Lange, Dylan W. (University Utrecht)
Fjølner, Jesper (Viborg Regional Hospital)
Leaver, Susannah (St George's Hospital)
Beil, Michael (Hebrew University of Jerusalem)
Sviri, Sigal (Hebrew University of Jerusalem)
Bruno, Raphael Romano (Heinrich-Heine-University Duesseldorf)
Artigas Raventós, Antoni (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
van Heerden, Peter Vernon (Hebrew University of Jerusalem)
Pinto, Bernardo Bollen (Geneva University Hospitals (Suïssa))
Schefold, Joerg C. (Bern University Hospital)
Moreno, Rui (UCentro Hospitalar Universitário de Lisboa Central)
Cecconi, Maurizio (Humanitas University (Itàlia))
Szczeklik, Wojciech (Jagiellonian University Medical College Center for Intensive Care and Perioperative Medicine)
Jung, Christian (Heinrich-Heine-University Duesseldorf)
Joannidis, Michael (Medical University Innsbruck)
Universitat Autònoma de Barcelona

Data:	2023
Resum:	Several studies have found an association between diabetes mellitus, disease severity and outcome in COVID-19 patients. Old critically ill patients are particularly at risk. This study aimed to investigate the impact of diabetes mellitus on 90-day mortality in a high-risk cohort of critically ill patients over 70 years of age. This multicentre international prospective cohort study was performed in 151 ICUs across 26 countries. We included patients ≥ 70 years of age with a confirmed SARS-CoV-2 infection admitted to the intensive care unit from 19th March 2020 through 15th July 2021. Patients were categorized into two groups according to the presence of diabetes mellitus. Primary outcome was 90-day mortality. Kaplan-Meier overall survival curves until day 90 were analysed and compared using the log-rank test. Mixed-effect Weibull regression models were computed to investigate the influence of diabetes mellitus on 90-day mortality. This study included 3420 patients with a median age of 76 years were included. Among these, 37. 3% (n = 1277) had a history of diabetes mellitus. Patients with diabetes showed higher rates of frailty (32% vs. 18%) and several comorbidities including chronic heart failure (20% vs. 11%), hypertension (79% vs. 59%) and chronic kidney disease (25% vs. 11%), but not of pulmonary comorbidities (22% vs. 22%). The 90-day mortality was significantly higher in patients with diabetes than those without diabetes (64% vs. 56%, p < 0. 001). The association of diabetes and 90-day mortality remained significant (HR 1. 18 [1. 06-1. 31], p = 0. 003) after adjustment for age, sex, SOFA-score and other comorbidities in a Weibull regression analysis. Diabetes mellitus was a relevant risk factor for 90-day mortality in old critically ill patients with COVID-19. NCT04321265, registered March 19th, 2020. The online version contains supplementary material available at 10. 1007/s15010-023-02001-2.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	SARS-CoV-2 ; Intensive care unit ; Elderly ; Old ; Critical care ; Ventilation ; Risk factors
Publicat a:	Infection, march 2023, p. 1-9, ISSN 1439-0973

DOI: 10.1007/s15010-023-02001-2
PMID: 36854893

9 p, 930.0 KB

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