- Among patients with diabetes hospitalized for COVID-19, 1 in 10 die within a week.
- BMI was independently associated with risk for tracheal intubation and/or death within 7 days, but HbA1c was not in this large French study.
Why this matters
- Specific characteristics predicting worse inpatient COVID-19 outcomes among patients with diabetes have not been identified.
- Observational study of 1317 patients with COVID-19 and diabetes at 53 French hospitals, March 10-31, 2020.
- Primary outcome: combined tracheal intubation for mechanical ventilation and/or death within 7 days of admission.
- Funding: Several French diabetes societies; Novo Nordisk; MSD; Abbott; AstraZeneca; others.
- Among the 1317 patients, at day 7:
- 29% had the primary composite outcome.
- 20.3% were intubated.
- 10.6% died.
- 18% were discharged.
- No associations were identified with HbA1c, renin-angiotensin-aldosterone system blockers, or dipeptidyl peptidase-4 inhibitors.
- In multivariable analysis, BMI was independently associated with the primary composite outcome:
- aOR: 1.28 for each standard deviation (95% CI, 1.10-1.47).
- Factors independently associated with death (ORs):
- Age: 2.39 (P<.0001>
- Macrovascular complications: 2.26 (P=.0069).
- Treated obstructive sleep apnea: 2.65 (P=.0044).
- Increased aspartate aminotransferase: 1.93 (P=.0001).
- C-reactive protein: 1.7 (P=.0202).
- Decreased estimated glomerular filtration rate: 0.51 (P<.0001>
- Platelet count: 0.66 (P=.0144).
- Inpatients only.
- Missing HbA1c data for 35.7%.
- No data for >7 days.