Clinical Characteristics and Outcomes of Patients With Diabetes and COVID-19 in Association With Glucose-Lowering Medication
Chen et al.,
Clinical Characteristics and Outcomes of Patients With Diabetes and COVID-19 in Association With..,
Diabetes Care, doi:10.2337/dc20-0660
Retrospective 120 COVID-19 diabetes patients, showing non-statistically significantly lower mortality with existing metformin treatment.
Although the 33% lower mortality is not statistically significant, it is consistent with the significant 32% lower mortality
[27‑37%] from meta analysis of the
46 mortality results to date.
risk of death, 33.0% lower, RR 0.67, p = 0.46, treatment 4 of 43 (9.3%), control 15 of 77 (19.5%), NNT 9.8, adjusted per study, odds ratio converted to relative risk.
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Chen et al., 31 Jul 2020, retrospective, China, peer-reviewed, 12 authors.
Abstract: Diabetes Care Volume 43, July 2020
Yuchen Chen,1 Dong Yang,1 Biao Cheng,2
Jian Chen,2 Anlin Peng,3 Chen Yang,1
Chong Liu,4 Mingrui Xiong,1 Aiping Deng,2
Yu Zhang,1 Ling Zheng,4 and Kun Huang1
Diabetes Care 2020;43:1399–1407 | https://doi.org/10.2337/dc20-0660
OBJECTIVE
Diabetes is one of the most distinct comorbidities of COVID-19. Here, we describe
the clinical characteristics of and outcomes in patients with diabetes in whom
COVID-19 was confirmed or clinically diagnosed (with typical features on lung
imaging and symptoms) and their association with glucose-lowering or blood
pressure–lowering medications.
RESEARCH DESIGN AND METHODS
In this retrospective study involving 904 patients with COVID-19 (136 with diabetes,
mostly type 2 diabetes), clinical and laboratory characteristics were collected and
compared between the group with diabetes and the group without diabetes, and
between groups taking different medications. Logistic regression was used to
explore risk factors associated with mortality or poor prognosis.
RESULTS
The proportion of comorbid diabetes is similar between cases of confirmed and of
clinically diagnosed COVID-19. Risk factors for higher mortality of patients with
diabetes and COVID-19 were older age (adjusted odds ratio [aOR] 1.09 [95% CI 1.04,
1.15] per year increase; P 5 0.001) and elevated C-reactive protein (aOR 1.12 [95% CI
1.00, 1.24]; P 5 0.043). Insulin usage (aOR 3.58 [95% CI 1.37, 9.35]; P 5 0.009) was
associated with poor prognosis. Clinical outcomes of those who use an ACE inhibitor
(ACEI) or angiotensin II type-I receptor blocker (ARB) were comparable with those of
patients who do not use ACEI/ARB among COVID-19 patients with diabetes and
hypertension.
1
Tongji School of Pharmacy, Tongji Medical
College, Huazhong University of Science and
Technology, Wuhan, China
2
Department of Pharmacy and the Center of
Information, The Central Hospital of Wuhan,
Tongji Medical College, Huazhong University
of Science and Technology, Wuhan, China
3
Department of Pharmacy, The Third Hospital of
Wuhan, Wuhan, China
4
Hubei Key Laboratory of Cell Homeostasis, College of Life Sciences, Wuhan University, Wuhan,
China
Corresponding authors: Kun Huang, kunhuang@
hust.edu.cn, and Ling Zheng, lzheng@whu.edu
.cn
Received 28 March 2020 and accepted 24 April
2020
This article contains supplementary material online
at https://doi.org/10.2337/figshare.12194748.
Y.C., D.Y., and B.C. contributed equally.
CONCLUSIONS
This article is part of a special article collection
available at https://care.diabetesjournals.org/
collection/diabetes-and-COVID19.
C-reactive protein may help to identify patients with diabetes who are at greater risk
of dying during hospitalization. Older patients with diabetes were prone to death
related to COVID-19. Attention needs to be paid to patients with diabetes and
COVID-19 who use insulin. ACEI/ARB use showed no significant impact on
patients with diabetes and hypertension who have COVID-19.
© 2020 by the American Diabetes Association.
Readers may use this article as long as the work is
properly cited, the use is educational and not for
profit, and the work is not altered. More information is available at https://www.diabetesjournals
.org/content/license.
DIABETES AND COVID-19
Clinical Characteristics and
Outcomes of Patients With
Diabetes and COVID-19 in
Association With GlucoseLowering Medication
1399
1400
Features of Patients With Diabetes and COVID-19
Coronavirus disease 2019 (COVID-19)..
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