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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Version: Final published version
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State: Public
Version: Final published version
License: Not specified
Serval ID
serval:BIB_01C6E08C8C53
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Diabetes mellitus is associated with 90-day mortality in old critically ill COVID-19 patients: a multicenter prospective observational cohort study.
Journal
Infection
Working group(s)
COVIP study group
Contributor(s)
Eller P., Mesotten D., Reper P., Oeyen S., Swinnen W., Brix H., Brushoej J., Villefrance M., Nedergaard H.K., Bjerregaard A.T., Balleby I.R., Andersen K., Hansen M.A., Uhrenholt S., Bundgaard H., Mohamed AARH, Salah R., Ali YKNM, Wassim K., Elgazzar Y.A., Tharwat S., Azzam A.Y., Habib A.A., Abosheaishaa H.M., Azab M.A., Galbois A., Charron C., Guerot E., Besch G., Rigaud J.P., Maizel J., Djibré M., Burtin P., Garcon P., Nseir S., Valette X., Alexandru N., Marin N., Vaissiere M., Plantefeve G., Vanderlinden T., Jurcisin I., Megarbane B., Caillard A., Valent A., Garnier M., Besset S., Oziel J., Raphaelen J.H., Dauger S., Dumas G., Goncalves B., Piton G., Kelm M., Wolff G., Barth E., Goebel U., Barth E., Kunstein A., Schuster M., Welte M., Lutz M., Meybohm P., Steiner S., Poerner T., Haake H., Schaller S., Kindgen-Milles D., Meyer C., Kurt M., Kuhn K.F., Randerath W., Wollborn J., Dindane Z., Kabitz H.J., Voigt I., Shala G., Faltlhauser A., Rovina N., Aidoni Z., Chrisanthopoulou E., Papadogoulas A., Gurjar M., Mahmoodpoor A., Ahmed A.K., Marsh B., Elsaka A., Comellini V., Rabha A., Ahmed H., A Namendys-Silva S., Ghannam A., Groenendijk M., Zegers M., de Lange D., Cornet A., Evers M., Haas L., Dormans T., Dieperink W., Romundstad L., Sjøbø B., Andersen F.H., Strietzel H.F., Olasveengen T., Hahn M., Czuczwar M., Gawda R., Klimkiewicz J., de Lurdes Campos Santos M., Gordinho A., Santos H., Assis R., Oliveira AIP, Badawy M.R., Perez-Torres D., Gomà G., Villamayor M.I., Mira A.P., Cubero P.J., Rivera S.A., Tomasa T., Iglesias D., Vázquez E.M., Aldecoa C., Ferreira A.F., Zalba-Etayo B., Canas-Perez I., Tamayo-Lomas L., Diaz-Rodriguez C., Sancho S., Priego J., Abualqumboz EMY, Hilles MMY, Saleh M., Ben-HAmouda N., Roberti A., Dullenkopf A., Fleury Y., Schefold J.C., Al-Sadawi M., Serck N., Dewaele E., Kumar P., Bundesen C., Innes R., Gooch J., Cagova L., Potter E., Reay M., Davey M., Humphreys S., Berlemont C.H., Chousterman B.G., Dépret F., Ferre A., Vettoretti L., Thevenin D., Faltlhauser A., Milovanovic M., Simon P., Lorenz M., Stoll S.E., Dubler S., Fuest K., Mulita F., Kondili E., Andrianopoulos I., Meynaar I., Cornet A.D., Sjøbøe B., Kluzik A., Zatorski P., Drygalski T., Solek-Pastuszka J., Onichimowski D., Stefaniak J., Stefanska-Wronka K., Zabul E., Cardoso F.S., Banzo MJA, Tomasa-Irriguible T.M., Mira Á.P., Arias-Rivera S., Frutos-Vivar F., Lopez-Cuenca S., de Gopegui P.R., Abidi N., Chau I., Pugh R., Smuts S., Zotter K.
ISSN
1439-0973 (Electronic)
ISSN-L
0300-8126
Publication state
Published
Issued date
10/2023
Peer-reviewed
Oui
Volume
51
Number
5
Pages
1407-1415
Language
english
Notes
Publication types: Multicenter Study ; Observational Study ; Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
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.
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.
Keywords
Humans, Aged, Aged, 80 and over, COVID-19, Prospective Studies, SARS-CoV-2, Critical Illness, Diabetes Mellitus/epidemiology, Intensive Care Units, Critical care, Elderly, Intensive care unit, Old, Risk factors, Ventilation
Pubmed
Web of science
Open Access
Yes
Create date
01/03/2023 16:18
Last modification date
25/01/2024 8:30