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Predictors of hospital discharge and mortality in patients with diabetes and COVID-19: updated results from the nationwide CORONADO study

for the CORONADO investigators, Matthieu Wargny, Louis Potier, Pierre Gourdy, Matthieu Pichelin, Coralie Amadou, Pierre‐Yves Benhamou, Jean‐Baptiste Bonnet, L. Bordier, Olivier Bourron, Claude Chaumeil, Nicolas Chevalier, Patrice Darmon, B. Delenne, Delphine Demarsy, Marie Dumas, O. Dupuy, Anna Flaus-Furmaniuk, Jean–François Gautier, A.M. Guedj, N. Jeandidier, Étienne Larger, Jean-Philippe Le Berre, Myriam Lungo, Nathanaëlle Montanier, Philippe Moulin, F. Plat, Vincent Rigalleau, René Robert, Dominique Seret‐Bégué, Pierre Sérusclat, Sarra Smati, Jean-François Thébaut, Blandine Tramunt, Camille Vatier, Fritz-Line Vélayoudom, Bruno Vergès, Patrice Winiszewski, Audrey Zabulon, Pierre‐Antoine Gourraud, Ronan Roussel, Bertrand Cariou, Samy Hadjadj

2021Diabetologia168 citationsDOIOpen Access PDF

Abstract

AIMS/HYPOTHESIS: This is an update of the results from the previous report of the CORONADO (Coronavirus SARS-CoV-2 and Diabetes Outcomes) study, which aims to describe the outcomes and prognostic factors in patients with diabetes hospitalised for coronavirus disease-2019 (COVID-19). METHODS: The CORONADO initiative is a French nationwide multicentre study of patients with diabetes hospitalised for COVID-19 with a 28-day follow-up. The patients were screened after hospital admission from 10 March to 10 April 2020. We mainly focused on hospital discharge and death within 28 days. RESULTS: . Microvascular and macrovascular diabetic complications were found in 44.2% and 38.6% of participants, respectively. Within 28 days, 1404 (50.2%; 95% CI 48.3%, 52.1%) were discharged from hospital with a median duration of hospital stay of 9 (5-14) days, while 577 participants died (20.6%; 95% CI 19.2%, 22.2%). In multivariable models, younger age, routine metformin therapy and longer symptom duration on admission were positively associated with discharge. History of microvascular complications, anticoagulant routine therapy, dyspnoea on admission, and higher aspartate aminotransferase, white cell count and C-reactive protein levels were associated with a reduced chance of discharge. Factors associated with death within 28 days mirrored those associated with discharge, and also included routine treatment by insulin and statin as deleterious factors. CONCLUSIONS/INTERPRETATION: In patients with diabetes hospitalised for COVID-19, we established prognostic factors for hospital discharge and death that could help clinicians in this pandemic period. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT04324736.

Topics & Concepts

MedicineDiabetes mellitusMetforminCoronavirus disease 2019 (COVID-19)Internal medicineEmergency medicineDiseasePediatricsInfectious disease (medical specialty)EndocrinologyCOVID-19 Clinical Research StudiesHyperglycemia and glycemic control in critically ill and hospitalized patientsDiabetes Treatment and Management
Predictors of hospital discharge and mortality in patients with diabetes and COVID-19: updated results from the nationwide CORONADO study | Litcius