15
IRUS Total
Downloads

Adverse outcomes in COVID-19 and diabetes – a retrospective cohort study from three London Teaching hospitals

File Description SizeFormat 
e001858.full.pdfPublished version727.7 kBAdobe PDFView/Open
Title: Adverse outcomes in COVID-19 and diabetes – a retrospective cohort study from three London Teaching hospitals
Authors: Izzi-Engbeaya, C
Distaso, W
Amin, A
Kenkre, J
Abdel-Malek, M
Hope, D
Oliver, N
Misra, S
Tan, T
Hill, N
Salem, V
Item Type: Journal Article
Abstract: INTRODUCTION: Patients with diabetes mellitus admitted to hospital with COVID-19 have poorer outcomes. However, the drivers for this are not fully elucidated. We performed detailed characterisation of COVID-19 patients to determine clinical and biochemical factors that may be the drivers of poorer outcomes. RESEARCH DESIGN AND METHODS: Retrospective cohort study of 889 consecutive inpatients diagnosed with COVID-19 between 9th March 2020 and 22nd April 2020 in a large London NHS Trust. Unbiased multivariate logistic regression analysis was performed to determine variables that were independently and significantly associated with increased risk of death and/or ICU admission within 30 days of COVID-19 diagnosis. RESULTS: 62% of patients in our cohort were of non-White ethnic backgrounds and the diabetes prevalence was 38%. 323 (36%) patients met the primary outcome of death/admission to the intensive care unit (ICU) within 30 days of COVID-19 diagnosis. Male gender, lower platelet count, advancing age and higher Clinical Frailty Scale (CFS) score (but not diabetes) independently predicted poor outcomes on multivariate analysis. Antiplatelet medication was associated with a lower risk of death/ICU admission. Factors that were significantly and independently associated with poorer outcomes in patients with diabetes were co-existing ischaemic heart disease, increasing age and lower platelet count. CONCLUSIONS: In this large study of a diverse patient population, comorbidity (i.e. diabetes with ischaemic heart disease; increasing CFS score in older patients) were major determinants of poor outcomes with COVID-19. Antiplatelet medication should be evaluated in randomised clinical trials amongst high-risk patient groups.
Issue Date: 6-Jan-2021
Date of Acceptance: 25-Nov-2020
URI: http://hdl.handle.net/10044/1/84807
DOI: 10.1136/bmjdrc-2020-001858
ISSN: 2052-4897
Publisher: BMJ Publishing Group
Start Page: 1
End Page: 10
Journal / Book Title: BMJ Open Diabetes Research and Care
Volume: 9
Issue: 1
Copyright Statement: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
Sponsor/Funder: Imperial College Healthcare NHS Trust- BRC Funding
Research Trainees Coordinating Centre
Funder's Grant Number: RDF01
DRF-2017-10-042
Keywords: Science & Technology
Life Sciences & Biomedicine
Endocrinology & Metabolism
type 1 diabetes mellitus
type 2 diabetes mellitus
infections
viruses
PNEUMONIA
FRAILTY
DISEASE
infections
type 1 diabetes mellitus
type 2 diabetes mellitus
viruses
Adult
Age Factors
Aged
Aged, 80 and over
COVID-19
Comorbidity
Diabetes Mellitus
Female
Frailty
Hospitals, Teaching
Humans
Intensive Care Units
Logistic Models
London
Male
Middle Aged
Multivariate Analysis
Retrospective Studies
Risk Factors
Sex Factors
Survival Rate
Young Adult
Humans
Diabetes Mellitus
Survival Rate
Multivariate Analysis
Logistic Models
Risk Factors
Retrospective Studies
Age Factors
Comorbidity
Sex Factors
Adult
Aged
Aged, 80 and over
Middle Aged
Hospitals, Teaching
Intensive Care Units
London
Female
Male
Young Adult
Frailty
COVID-19
1103 Clinical Sciences
Publication Status: Published
Online Publication Date: 2021-01-06
Appears in Collections:Imperial College Business School
Department of Metabolism, Digestion and Reproduction
Bioengineering
Faculty of Medicine
Grantham Institute for Climate Change
Imperial College London COVID-19
Faculty of Natural Sciences
Faculty of Engineering



This item is licensed under a Creative Commons License Creative Commons