Diabetes mellitus is associated with 90-day mortality in old critically ill COVID-19 patients: a multicenter prospective observational cohort study.
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BORIS DOI
Date of Publication
October 2023
Publication Type
Article
Division/Institute
Contributor
Mayerhöfer, Timo | |
Klein, Sebastian | |
Wernly, Bernhard | |
Flaatten, Hans | |
Guidet, Bertrand | |
De Lange, Dylan W | |
Fjølner, Jesper | |
Leaver, Susannah | |
Beil, Michael | |
Sviri, Sigal | |
Bruno, Raphael Romano | |
Artigas, Antonio | |
van Heerden, Peter Vernon | |
Pinto, Bernardo Bollen | |
Moreno, Rui | |
Cecconi, Maurizio | |
Szczeklik, Wojciech | |
Jung, Christian | |
Joannidis, Michael |
Subject(s)
Series
Infection
ISSN or ISBN (if monograph)
0300-8126
Publisher
Springer-Medizin-Verlag
Language
English
Publisher DOI
PubMed ID
36854893
Uncontrolled Keywords
Description
BACKGROUND
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.
METHODS
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.
RESULTS
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.
CONCLUSION
Diabetes mellitus was a relevant risk factor for 90-day mortality in old critically ill patients with COVID-19.
STUDY REGISTRATION
NCT04321265, registered March 19th, 2020.
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.
METHODS
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.
RESULTS
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.
CONCLUSION
Diabetes mellitus was a relevant risk factor for 90-day mortality in old critically ill patients with COVID-19.
STUDY REGISTRATION
NCT04321265, registered March 19th, 2020.
File(s)
| File | File Type | Format | Size | License | Publisher/Copright statement | Content | |
|---|---|---|---|---|---|---|---|
| s15010-023-02001-2.pdf | text | Adobe PDF | 930.01 KB | published |