Critically ill patients with diabetes and Middle East respiratory syndrome: a multi-center observational study.
Adrenal Cortex Hormones
Adult
Age Factors
Aged
Bronchoalveolar Lavage Fluid
/ virology
Cohort Studies
Comorbidity
Coronavirus Infections
/ complications
Critical Illness
Diabetes Complications
/ epidemiology
Diabetes Mellitus
/ epidemiology
Female
Humans
Male
Middle Aged
Middle East Respiratory Syndrome Coronavirus
/ genetics
Nasopharynx
/ virology
Respiratory Insufficiency
/ etiology
Retrospective Studies
Risk Factors
Saudi Arabia
/ epidemiology
Sputum
/ virology
Trachea
/ virology
Acute respiratory distress syndrome
Coronavirus
Diabetes
Middle East respiratory syndrome
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
19 Jan 2021
19 Jan 2021
Historique:
received:
12
08
2020
accepted:
06
01
2021
entrez:
20
1
2021
pubmed:
21
1
2021
medline:
29
1
2021
Statut:
epublish
Résumé
Diabetes is a risk factor for infection with coronaviruses. This study describes the demographic, clinical data, and outcomes of critically ill patients with diabetes and Middle East Respiratory Syndrome (MERS). This retrospective cohort study was conducted at 14 hospitals in Saudi Arabia (September 2012-January 2018). We compared the demographic characteristics, underlying medical conditions, presenting symptoms and signs, management and clinical course, and outcomes of critically ill patients with MERS who had diabetes compared to those with no diabetes. Multivariable logistic regression analysis was performed to determine if diabetes was an independent predictor of 90-day mortality. Of the 350 critically ill patients with MERS, 171 (48.9%) had diabetes. Patients with diabetes were more likely to be older, and have comorbid conditions, compared to patients with no diabetes. They were more likely to present with respiratory failure requiring intubation, vasopressors, and corticosteroids. The median time to clearance of MERS-CoV RNA was similar (23 days (Q1, Q3: 17, 36) in patients with diabetes and 21.0 days (Q1, Q3: 10, 33) in patients with no diabetes). Mortality at 90 days was higher in patients with diabetes (78.9% versus 54.7%, p < 0.0001). Multivariable regression analysis showed that diabetes was an independent risk factor for 90-day mortality (odds ratio, 2.09; 95% confidence interval, 1.18-3.72). Half of the critically ill patients with MERS have diabetes; which is associated with more severe disease. Diabetes is an independent predictor of mortality among critically patients with MERS.
Sections du résumé
BACKGROUND
BACKGROUND
Diabetes is a risk factor for infection with coronaviruses. This study describes the demographic, clinical data, and outcomes of critically ill patients with diabetes and Middle East Respiratory Syndrome (MERS).
METHODS
METHODS
This retrospective cohort study was conducted at 14 hospitals in Saudi Arabia (September 2012-January 2018). We compared the demographic characteristics, underlying medical conditions, presenting symptoms and signs, management and clinical course, and outcomes of critically ill patients with MERS who had diabetes compared to those with no diabetes. Multivariable logistic regression analysis was performed to determine if diabetes was an independent predictor of 90-day mortality.
RESULTS
RESULTS
Of the 350 critically ill patients with MERS, 171 (48.9%) had diabetes. Patients with diabetes were more likely to be older, and have comorbid conditions, compared to patients with no diabetes. They were more likely to present with respiratory failure requiring intubation, vasopressors, and corticosteroids. The median time to clearance of MERS-CoV RNA was similar (23 days (Q1, Q3: 17, 36) in patients with diabetes and 21.0 days (Q1, Q3: 10, 33) in patients with no diabetes). Mortality at 90 days was higher in patients with diabetes (78.9% versus 54.7%, p < 0.0001). Multivariable regression analysis showed that diabetes was an independent risk factor for 90-day mortality (odds ratio, 2.09; 95% confidence interval, 1.18-3.72).
CONCLUSIONS
CONCLUSIONS
Half of the critically ill patients with MERS have diabetes; which is associated with more severe disease. Diabetes is an independent predictor of mortality among critically patients with MERS.
Identifiants
pubmed: 33468070
doi: 10.1186/s12879-021-05771-y
pii: 10.1186/s12879-021-05771-y
pmc: PMC7814976
doi:
Substances chimiques
Adrenal Cortex Hormones
0
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
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