The association of diabetes and the prognosis of COVID-19 patients: A retrospective study

https://doi.org/10.1016/j.diabres.2020.108386Get rights and content

Highlights

  • COVID-19 patients with poorly-controlled HbA1c showed increased worsening rate.

  • A HbA1c level of 8.6% (70 mmol/mol) was the optimal cutoff value.

  • Antidiabetic/antihypertensive drug use was not related to worsening in COVID-19 patients.

Abstract

Aims

This study evaluated the impact of previous glycemic control and in-hospital use of antidiabetic/antihypertensive drugs on the prognosis of COVID-19 patients with diabetes.

Methods

In this retrospective cohort study, consecutive inpatients with laboratory confirmed COVID-19 were enrolled from Tongji Hospital (Wuhan, China). Patients without diabetes were matched to those with diabetes based on age, sex, and comorbidities. All patients were followed up to a clinical endpoint (discharge, worsening including transferring to ICU or immediate death). Data and outcomes were extracted from medical records and analyzed.

Results

64 patients with pre-existing diabetes were included in this study, with 128 matched patients without diabetes included as a control group. Patients with diabetes had a higher rate of worsening (18.8% versus 7.8%, p = 0.025). Multivariable regression showed increased odds of worsening associated with previous glycemic control reflected by HbA1c (odds ratio 3.29, 95% CI 1.19–9.13, p = 0.022) and receiver-operating characteristics (ROC) curve identified HbA1c of 8.6% (70 mmol/mol) as the optimal cut-off value. Univariate analysis demonstrated the in-hospital use of antidiabetic/antihypertensive drugs were not associated with a higher risk of worsening.

Conclusions

COVID-19 patients with diabetes had a higher risk of worsening, especially those with poorly-controlled HbA1c, with an optimal cut-off value of 8.6%. The in-hospital use of antidiabetic/antihypertensive drugs were not associated with increased odds of worsening in patients with diabetes.

Keywords

Antidiabetic drugs
Antihypertensive drugs
COVID-19
Diabetes
HbA1c

Abbreviations

ACE-2
Angiotensin-converting enzyme 2
ACEI
Angiotensin-converting enzyme inhibitor
ARB
Angiotensin II receptor 1 blocker
BG
Blood glucose
CCB
Calcium channel blocker
cTnI
Cardiac troponin I
CRP
C-reactive protein
DM
Diabetes mellitus
HbA1c
Glycated hemoglobin A1c
ICU
Intensive care unit
COVID-19
Novel coronavirus disease 2019
NT-proBNP
N-terminal brain natriuretic peptide precursor
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2

Cited by (0)

1

Zhelong Liu and Xi Bai contributed equally to this article.

View Abstract