Association of COVID-19 outcomes with diabetes in the Veneto region (north-east italy): Epidemiological insights for the endemic phase?

COVID-19 Diabetes Hypertension Metabolic control RAAS-i

Journal

Nutrition, metabolism, and cardiovascular diseases : NMCD
ISSN: 1590-3729
Titre abrégé: Nutr Metab Cardiovasc Dis
Pays: Netherlands
ID NLM: 9111474

Informations de publication

Date de publication:
Nov 2023
Historique:
received: 09 03 2023
revised: 29 05 2023
accepted: 20 06 2023
pubmed: 6 8 2023
medline: 6 8 2023
entrez: 5 8 2023
Statut: ppublish

Résumé

Diabetes mellitus is a prevalent chronic disease in patients who die of COVID-19. The aim of this study was to investigate the clinical and metabolic characteristics of diabetic patients with COVID-19 during the pre-vaccination phase. A retrospective cohort study was conducted from February 2020 to February 2021 to examine the clinical and metabolic profiles of unvaccinated diabetic patients affected by COVID-19. Data were collected from claim databases, hospital discharge records, and clinical records within a healthcare district located in northeastern Italy with a population of 936,000. Potential prognostic indicators including sex, age, Body Mass Index (BMI), duration and type of diabetes, metabolic control, and the use of antidiabetic, antihypertensive, lipid-lowering, and antiplatelet therapies were investigated. For hospitalized patients, additional variables were recorded, such as length of hospital stay, blood pressure at admission, comorbidities, D-dimer levels, blood glucose (BG), in-hospital insulin and corticosteroid therapies, requirement for mechanical ventilation (i.e., orotracheal or tracheostomy), admission to the Intensive Care Unit (ICU), and mortality. Diabetic patients hospitalized for COVID-19 with a poorer prognosis were characterized by advanced age, longer diabetes duration, hypertension, higher usage of sulfonylureas, and lower usage of dietotherapy alone, metformin, Glucagon-Like Peptide-1 Receptor agonists (GLP1-Ra), and Renin-Angiotensin-Aldosterone System inhibitors (RAAS-i). Considering the potential for COVID-19 to become endemic, special care should be taken in managing older diabetic patients' treatments.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
Diabetes mellitus is a prevalent chronic disease in patients who die of COVID-19. The aim of this study was to investigate the clinical and metabolic characteristics of diabetic patients with COVID-19 during the pre-vaccination phase.
METHODS AND RESULTS RESULTS
A retrospective cohort study was conducted from February 2020 to February 2021 to examine the clinical and metabolic profiles of unvaccinated diabetic patients affected by COVID-19. Data were collected from claim databases, hospital discharge records, and clinical records within a healthcare district located in northeastern Italy with a population of 936,000. Potential prognostic indicators including sex, age, Body Mass Index (BMI), duration and type of diabetes, metabolic control, and the use of antidiabetic, antihypertensive, lipid-lowering, and antiplatelet therapies were investigated. For hospitalized patients, additional variables were recorded, such as length of hospital stay, blood pressure at admission, comorbidities, D-dimer levels, blood glucose (BG), in-hospital insulin and corticosteroid therapies, requirement for mechanical ventilation (i.e., orotracheal or tracheostomy), admission to the Intensive Care Unit (ICU), and mortality. Diabetic patients hospitalized for COVID-19 with a poorer prognosis were characterized by advanced age, longer diabetes duration, hypertension, higher usage of sulfonylureas, and lower usage of dietotherapy alone, metformin, Glucagon-Like Peptide-1 Receptor agonists (GLP1-Ra), and Renin-Angiotensin-Aldosterone System inhibitors (RAAS-i).
CONCLUSION CONCLUSIONS
Considering the potential for COVID-19 to become endemic, special care should be taken in managing older diabetic patients' treatments.

Identifiants

pubmed: 37543520
pii: S0939-4753(23)00249-1
doi: 10.1016/j.numecd.2023.06.016
pmc: PMC10290544
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2141-2150

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors have no conflicts of interest to declare that are relevant to the content of this article. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Auteurs

Francesco Piarulli (F)

Department of Medicine, University of Padova, 35128, Padova, Italy. Electronic address: francesco.piarulli@unipd.it.

Massimo Carollo (M)

Department of Medicine, University of Padova, 35128, Padova, Italy. Electronic address: drmassimocarollo@gmail.com.

Eugenio Ragazzi (E)

Department of Pharmaceutical and Pharmacological Sciences (DSF), University of Padova School of Medicine and Surgery, 35131, Padova, Italy. Electronic address: eugenio.ragazzi@unipd.it.

Luca Benacchio (L)

Epidemiology Unit, LHU 6 Padova, Padua, Italy. Electronic address: luca.benacchio@aulss6.veneto.it.

Fabio Piovanello (F)

Information Systems, AULSS 6 Euganea, Padua, Italy. Electronic address: fabio.piovanello@aulss6.veneto.it.

Ivana Simoncello (I)

Public Health Department, Padua Local Health Unit, Padua, Italy. Electronic address: ivana.simoncello@libero.it.

Annunziata Lapolla (A)

Department of Medicine, University of Padova, 35128, Padova, Italy. Electronic address: annunziata.lapolla@unipd.it.

Classifications MeSH