Ann Endocrinol (Paris). 2023 Aug 11:S0003-4266(23)00685-6. doi: 10.1016/j.ando.2023.08.002. Online ahead of print.
ABSTRACT
BACKGROUND AND AIMS: We describe mortality-related risk factors of inpatients with diabetes and coronavirus disease 2019 (COVID-19) in Belgium.
METHODS: We conducted a multicenter retrospective study from March to May, 2020, in 8 Belgian centers. Data on admission of patients with diabetes and COVID-19 were collected. Survivors were compared to non-survivors to identify prognostic risk factors for in-hospital death, using multivariate analysis in both the total population and in the subgroup of patients admitted to the intensive care unit (ICU).
RESULTS: The study included 375 patients. The mortality rate was 26.4% (99/375) in the total population and 40% (27/67) in the ICU. Multivariate analysis identified older age (HR 1.05 [CI 1.03-1.07], p <0.0001) and male gender (HR 2.01 [1.31-3.07], p 0.0013) as the main independent risk factors for in-hospital death in the total population. Use of metformin (HR 0.51 [0.34-0.78], p 0.0018) and renin-angiotensin-aldosterone system blockers (HR 0.56 [0.36-0.86], p 0.0088) before admission were independent protective factors. In the ICU, chronic kidney disease (CKD) was identified as an independent risk factor for death (HR 4.96 [2.14-11.5], p <0.001).
CONCLUSION: In-hospital mortality due to the first wave of the COVID-19 pandemic in Belgium was high in patients with diabetes. We found that advanced age and male gender were independent risk factors for in-hospital death. We also showed that metformin use before admission was associated with significantly lower COVID-19-related in-hospital mortality. Finally, we showed that CKD is a COVID-19-related mortality risk factor in patients with diabetes admitted to the ICU.
PMID:37574109 | DOI:10.1016/j.ando.2023.08.002
