Clinical Characteristics and Risk Factors for Mortality of COVID-19 Patients With Diabetes in Wuhan, China: A Two-Center, Retrospective Study

Diabetes is common in COVID-19 patients and associated with unfavorable outcomes. We aimed to describe the characteristics and outcomes and to analyze the risk factors for in-hospital mortality of COVID-19 patients with diabetes. This two-center retrospective study was performed at two tertiary hosp...

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Veröffentlicht in:Diabetes care 2020-07, Vol.43 (7), p.1382-1391
Hauptverfasser: Shi, Qiao, Zhang, Xiaoyi, Jiang, Fang, Zhang, Xuanzhe, Hu, Ning, Bimu, Chibu, Feng, Jiarui, Yan, Su, Guan, Yongjun, Xu, Dongxue, He, Guangzhen, Chen, Chen, Xiong, Xingcheng, Liu, Lei, Li, Hanjun, Tao, Jing, Peng, Zhiyong, Wang, Weixing
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container_end_page 1391
container_issue 7
container_start_page 1382
container_title Diabetes care
container_volume 43
creator Shi, Qiao
Zhang, Xiaoyi
Jiang, Fang
Zhang, Xuanzhe
Hu, Ning
Bimu, Chibu
Feng, Jiarui
Yan, Su
Guan, Yongjun
Xu, Dongxue
He, Guangzhen
Chen, Chen
Xiong, Xingcheng
Liu, Lei
Li, Hanjun
Tao, Jing
Peng, Zhiyong
Wang, Weixing
description Diabetes is common in COVID-19 patients and associated with unfavorable outcomes. We aimed to describe the characteristics and outcomes and to analyze the risk factors for in-hospital mortality of COVID-19 patients with diabetes. This two-center retrospective study was performed at two tertiary hospitals in Wuhan, China. Confirmed COVID-19 patients with diabetes ( = 153) who were discharged or died from 1 January 2020 to 8 March 2020 were identified. One sex- and age-matched COVID-19 patient without diabetes was randomly selected for each patient with diabetes. Demographic, clinical, and laboratory data were abstracted. Cox proportional hazards regression analyses were performed to identify the risk factors associated with the mortality in these patients. Of 1,561 COVID-19 patients, 153 (9.8%) had diabetes, with a median age of 64.0 (interquartile range 56.0-72.0) years. A higher proportion of intensive care unit admission (17.6% vs. 7.8%, = 0.01) and more fatal cases (20.3% vs. 10.5%, = 0.017) were identified in COVID-19 patients with diabetes than in the matched patients. Multivariable Cox regression analyses of these 306 patients showed that hypertension (hazard ratio [HR] 2.50, 95% CI 1.30-4.78), cardiovascular disease (HR 2.24, 95% CI 1.19-4.23), and chronic pulmonary disease (HR 2.51, 95% CI 1.07-5.90) were independently associated with in-hospital death. Diabetes (HR 1.58, 95% CI 0.84-2.99) was not statistically significantly associated with in-hospital death after adjustment. Among patients with diabetes, nonsurvivors were older (76.0 vs. 63.0 years), most were male (71.0% vs. 29.0%), and they were more likely to have underlying hypertension (83.9% vs. 50.0%) and cardiovascular disease (45.2% vs. 14.8%) (all values
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We aimed to describe the characteristics and outcomes and to analyze the risk factors for in-hospital mortality of COVID-19 patients with diabetes. This two-center retrospective study was performed at two tertiary hospitals in Wuhan, China. Confirmed COVID-19 patients with diabetes ( = 153) who were discharged or died from 1 January 2020 to 8 March 2020 were identified. One sex- and age-matched COVID-19 patient without diabetes was randomly selected for each patient with diabetes. Demographic, clinical, and laboratory data were abstracted. Cox proportional hazards regression analyses were performed to identify the risk factors associated with the mortality in these patients. Of 1,561 COVID-19 patients, 153 (9.8%) had diabetes, with a median age of 64.0 (interquartile range 56.0-72.0) years. A higher proportion of intensive care unit admission (17.6% vs. 7.8%, = 0.01) and more fatal cases (20.3% vs. 10.5%, = 0.017) were identified in COVID-19 patients with diabetes than in the matched patients. Multivariable Cox regression analyses of these 306 patients showed that hypertension (hazard ratio [HR] 2.50, 95% CI 1.30-4.78), cardiovascular disease (HR 2.24, 95% CI 1.19-4.23), and chronic pulmonary disease (HR 2.51, 95% CI 1.07-5.90) were independently associated with in-hospital death. Diabetes (HR 1.58, 95% CI 0.84-2.99) was not statistically significantly associated with in-hospital death after adjustment. Among patients with diabetes, nonsurvivors were older (76.0 vs. 63.0 years), most were male (71.0% vs. 29.0%), and they were more likely to have underlying hypertension (83.9% vs. 50.0%) and cardiovascular disease (45.2% vs. 14.8%) (all values &lt;0.05). Age ≥70 years (HR 2.39, 95% CI 1.03-5.56) and hypertension (HR 3.10, 95% CI 1.14-8.44) were independent risk factors for in-hospital death of patients with diabetes. COVID-19 patients with diabetes had worse outcomes compared with the sex- and age-matched patients without diabetes. Older age and comorbid hypertension independently contributed to in-hospital death of patients with diabetes.</description><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1935-5548</identifier><identifier>DOI: 10.2337/dc20-0598</identifier><identifier>PMID: 32409504</identifier><language>eng</language><publisher>United States: American Diabetes Association</publisher><subject>Age ; Aged ; Betacoronavirus ; Cardiovascular disease ; Cardiovascular diseases ; Comorbidity ; Coronavirus Infections - mortality ; Coronavirus Infections - physiopathology ; Coronaviruses ; COVID-19 ; Death ; Diabetes ; Diabetes mellitus ; Diabetes Mellitus, Type 2 - mortality ; Diabetes Mellitus, Type 2 - physiopathology ; Fatalities ; Female ; Hazard identification ; Health hazards ; Hospital Mortality ; Hospitalization ; Humans ; Hypertension ; Hypertension - mortality ; Lung diseases ; Male ; Middle Aged ; Mortality ; Pandemics ; Patients ; Pneumonia, Viral - mortality ; Pneumonia, Viral - physiopathology ; Proportional Hazards Models ; Regression analysis ; Research design ; Retrospective Studies ; Risk analysis ; Risk Factors ; SARS-CoV-2 ; Sex</subject><ispartof>Diabetes care, 2020-07, Vol.43 (7), p.1382-1391</ispartof><rights>2020 by the American Diabetes Association.</rights><rights>Copyright American Diabetes Association Jul 1, 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c313t-cff607402ff1cb58aea39f2374b7257dc3a2b1b81e90c1c84b656c7566b2ac413</citedby><cites>FETCH-LOGICAL-c313t-cff607402ff1cb58aea39f2374b7257dc3a2b1b81e90c1c84b656c7566b2ac413</cites><orcidid>0000-0002-3873-9607 ; 0000-0002-3854-0083</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32409504$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shi, Qiao</creatorcontrib><creatorcontrib>Zhang, Xiaoyi</creatorcontrib><creatorcontrib>Jiang, Fang</creatorcontrib><creatorcontrib>Zhang, Xuanzhe</creatorcontrib><creatorcontrib>Hu, Ning</creatorcontrib><creatorcontrib>Bimu, Chibu</creatorcontrib><creatorcontrib>Feng, Jiarui</creatorcontrib><creatorcontrib>Yan, Su</creatorcontrib><creatorcontrib>Guan, Yongjun</creatorcontrib><creatorcontrib>Xu, Dongxue</creatorcontrib><creatorcontrib>He, Guangzhen</creatorcontrib><creatorcontrib>Chen, Chen</creatorcontrib><creatorcontrib>Xiong, Xingcheng</creatorcontrib><creatorcontrib>Liu, Lei</creatorcontrib><creatorcontrib>Li, Hanjun</creatorcontrib><creatorcontrib>Tao, Jing</creatorcontrib><creatorcontrib>Peng, Zhiyong</creatorcontrib><creatorcontrib>Wang, Weixing</creatorcontrib><title>Clinical Characteristics and Risk Factors for Mortality of COVID-19 Patients With Diabetes in Wuhan, China: A Two-Center, Retrospective Study</title><title>Diabetes care</title><addtitle>Diabetes Care</addtitle><description>Diabetes is common in COVID-19 patients and associated with unfavorable outcomes. We aimed to describe the characteristics and outcomes and to analyze the risk factors for in-hospital mortality of COVID-19 patients with diabetes. This two-center retrospective study was performed at two tertiary hospitals in Wuhan, China. Confirmed COVID-19 patients with diabetes ( = 153) who were discharged or died from 1 January 2020 to 8 March 2020 were identified. One sex- and age-matched COVID-19 patient without diabetes was randomly selected for each patient with diabetes. Demographic, clinical, and laboratory data were abstracted. Cox proportional hazards regression analyses were performed to identify the risk factors associated with the mortality in these patients. Of 1,561 COVID-19 patients, 153 (9.8%) had diabetes, with a median age of 64.0 (interquartile range 56.0-72.0) years. A higher proportion of intensive care unit admission (17.6% vs. 7.8%, = 0.01) and more fatal cases (20.3% vs. 10.5%, = 0.017) were identified in COVID-19 patients with diabetes than in the matched patients. Multivariable Cox regression analyses of these 306 patients showed that hypertension (hazard ratio [HR] 2.50, 95% CI 1.30-4.78), cardiovascular disease (HR 2.24, 95% CI 1.19-4.23), and chronic pulmonary disease (HR 2.51, 95% CI 1.07-5.90) were independently associated with in-hospital death. Diabetes (HR 1.58, 95% CI 0.84-2.99) was not statistically significantly associated with in-hospital death after adjustment. Among patients with diabetes, nonsurvivors were older (76.0 vs. 63.0 years), most were male (71.0% vs. 29.0%), and they were more likely to have underlying hypertension (83.9% vs. 50.0%) and cardiovascular disease (45.2% vs. 14.8%) (all values &lt;0.05). Age ≥70 years (HR 2.39, 95% CI 1.03-5.56) and hypertension (HR 3.10, 95% CI 1.14-8.44) were independent risk factors for in-hospital death of patients with diabetes. COVID-19 patients with diabetes had worse outcomes compared with the sex- and age-matched patients without diabetes. 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Zhang, Xiaoyi ; Jiang, Fang ; Zhang, Xuanzhe ; Hu, Ning ; Bimu, Chibu ; Feng, Jiarui ; Yan, Su ; Guan, Yongjun ; Xu, Dongxue ; He, Guangzhen ; Chen, Chen ; Xiong, Xingcheng ; Liu, Lei ; Li, Hanjun ; Tao, Jing ; Peng, Zhiyong ; Wang, Weixing</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c313t-cff607402ff1cb58aea39f2374b7257dc3a2b1b81e90c1c84b656c7566b2ac413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Age</topic><topic>Aged</topic><topic>Betacoronavirus</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Comorbidity</topic><topic>Coronavirus Infections - mortality</topic><topic>Coronavirus Infections - physiopathology</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>Death</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes Mellitus, Type 2 - mortality</topic><topic>Diabetes Mellitus, Type 2 - physiopathology</topic><topic>Fatalities</topic><topic>Female</topic><topic>Hazard identification</topic><topic>Health hazards</topic><topic>Hospital Mortality</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - mortality</topic><topic>Lung diseases</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Pandemics</topic><topic>Patients</topic><topic>Pneumonia, Viral - mortality</topic><topic>Pneumonia, Viral - physiopathology</topic><topic>Proportional Hazards Models</topic><topic>Regression analysis</topic><topic>Research design</topic><topic>Retrospective Studies</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>SARS-CoV-2</topic><topic>Sex</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shi, Qiao</creatorcontrib><creatorcontrib>Zhang, Xiaoyi</creatorcontrib><creatorcontrib>Jiang, Fang</creatorcontrib><creatorcontrib>Zhang, Xuanzhe</creatorcontrib><creatorcontrib>Hu, Ning</creatorcontrib><creatorcontrib>Bimu, Chibu</creatorcontrib><creatorcontrib>Feng, Jiarui</creatorcontrib><creatorcontrib>Yan, Su</creatorcontrib><creatorcontrib>Guan, Yongjun</creatorcontrib><creatorcontrib>Xu, Dongxue</creatorcontrib><creatorcontrib>He, Guangzhen</creatorcontrib><creatorcontrib>Chen, Chen</creatorcontrib><creatorcontrib>Xiong, Xingcheng</creatorcontrib><creatorcontrib>Liu, Lei</creatorcontrib><creatorcontrib>Li, Hanjun</creatorcontrib><creatorcontrib>Tao, Jing</creatorcontrib><creatorcontrib>Peng, Zhiyong</creatorcontrib><creatorcontrib>Wang, Weixing</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health &amp; 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We aimed to describe the characteristics and outcomes and to analyze the risk factors for in-hospital mortality of COVID-19 patients with diabetes. This two-center retrospective study was performed at two tertiary hospitals in Wuhan, China. Confirmed COVID-19 patients with diabetes ( = 153) who were discharged or died from 1 January 2020 to 8 March 2020 were identified. One sex- and age-matched COVID-19 patient without diabetes was randomly selected for each patient with diabetes. Demographic, clinical, and laboratory data were abstracted. Cox proportional hazards regression analyses were performed to identify the risk factors associated with the mortality in these patients. Of 1,561 COVID-19 patients, 153 (9.8%) had diabetes, with a median age of 64.0 (interquartile range 56.0-72.0) years. A higher proportion of intensive care unit admission (17.6% vs. 7.8%, = 0.01) and more fatal cases (20.3% vs. 10.5%, = 0.017) were identified in COVID-19 patients with diabetes than in the matched patients. Multivariable Cox regression analyses of these 306 patients showed that hypertension (hazard ratio [HR] 2.50, 95% CI 1.30-4.78), cardiovascular disease (HR 2.24, 95% CI 1.19-4.23), and chronic pulmonary disease (HR 2.51, 95% CI 1.07-5.90) were independently associated with in-hospital death. Diabetes (HR 1.58, 95% CI 0.84-2.99) was not statistically significantly associated with in-hospital death after adjustment. Among patients with diabetes, nonsurvivors were older (76.0 vs. 63.0 years), most were male (71.0% vs. 29.0%), and they were more likely to have underlying hypertension (83.9% vs. 50.0%) and cardiovascular disease (45.2% vs. 14.8%) (all values &lt;0.05). Age ≥70 years (HR 2.39, 95% CI 1.03-5.56) and hypertension (HR 3.10, 95% CI 1.14-8.44) were independent risk factors for in-hospital death of patients with diabetes. COVID-19 patients with diabetes had worse outcomes compared with the sex- and age-matched patients without diabetes. Older age and comorbid hypertension independently contributed to in-hospital death of patients with diabetes.</abstract><cop>United States</cop><pub>American Diabetes Association</pub><pmid>32409504</pmid><doi>10.2337/dc20-0598</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-3873-9607</orcidid><orcidid>https://orcid.org/0000-0002-3854-0083</orcidid></addata></record>
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subjects Age
Aged
Betacoronavirus
Cardiovascular disease
Cardiovascular diseases
Comorbidity
Coronavirus Infections - mortality
Coronavirus Infections - physiopathology
Coronaviruses
COVID-19
Death
Diabetes
Diabetes mellitus
Diabetes Mellitus, Type 2 - mortality
Diabetes Mellitus, Type 2 - physiopathology
Fatalities
Female
Hazard identification
Health hazards
Hospital Mortality
Hospitalization
Humans
Hypertension
Hypertension - mortality
Lung diseases
Male
Middle Aged
Mortality
Pandemics
Patients
Pneumonia, Viral - mortality
Pneumonia, Viral - physiopathology
Proportional Hazards Models
Regression analysis
Research design
Retrospective Studies
Risk analysis
Risk Factors
SARS-CoV-2
Sex
title Clinical Characteristics and Risk Factors for Mortality of COVID-19 Patients With Diabetes in Wuhan, China: A Two-Center, Retrospective Study
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