DOI record:
{
"DOI": "10.21203/rs.3.rs-133358/v1",
"URL": "http://dx.doi.org/10.21203/rs.3.rs-133358/v1",
"abstract": "<jats:title>Abstract</jats:title>\n <jats:p>Background\n\nAdvanced age and diabetes are both associated with poor prognosis in COVID-19. However, the effects of cardiometabolic drugs on the prognosis of diabetic patients with COVID-19, especially very old patients, are not well-known. This work aims to analyze the association between preadmission cardiometabolic therapy (antidiabetic, antiaggregant, antihypertensive, and lipid-lowering drugs) and in-hospital mortality among patients ≥ 80 years with type 2 diabetes mellitus hospitalized for COVID-19.\nMethods\n\nWe conducted a nationwide, multicenter, retrospective, observational study in patients ≥ 80 years with type 2 diabetes mellitus and COVID-19 hospitalized in 160 Spanish hospitals between March 1 and May 29, 2020 who were included in the SEMI-COVID-19 Registry. The primary outcome measure was in-hospital mortality. A multivariate logistic regression analysis were performed to assess the association between preadmission cardiometabolic therapy and in-hospital mortality. The regression analysis values were expressed as adjusted odds ratios (AOR) with a 95% confidence interval (CI). In order to select the variables, the forward selection Wald statistic was used. Discrimination of the fitted logistic model was assessed via a receiver operating characteristic (ROC) curve. The Hosmer-Lemeshow test for logistic regression was used to determine the model’s goodness of fit.\nResults\n\nOf the 2,763 patients ≥80 years old hospitalized due to COVID-19, 790 (28.6%) had T2DM. Of these patients, 385 (48.7%) died during admission. On the multivariate analysis, the use of dipeptidyl peptidase-4 inhibitors (AOR 0.502, 95% CI 0.309–0.815, p = 0.005) and angiotensin receptor blockers (AOR 0.454, 95% CI 0.274–0.759, p = 0.003) were independent protectors against in-hospital mortality whereas the use of acetylsalicylic acid was associated with higher in-hospital mortality (AOR 1.761, 95% CI 1.092–2.842, p = 0.020). Other antidiabetic drugs, angiotensin-converting enzyme inhibitors and statins showed neutral association with in-hospital mortality. The model showed an area under the curve of 0.788.\nConclusions\n\nWe found important differences between cardiometabolic drugs and in-hospital mortality in older patients with type 2 diabetes mellitus hospitalized for COVID-19. Preadmission treatment with dipeptidyl peptidase-4 inhibitors and angiotensin receptor blockers may reduce in-hospital mortality; other antidiabetic drugs, angiotensin-converting enzyme inhibitors and statins seem to have a neutral effect; and acetylsalicylic acid may be associated with excess mortality.</jats:p>",
"accepted": {
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2020,
12,
21
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"author": [
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"affiliation": [
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"name": "Miguel Hernandez University of Elche: Universidad Miguel Hernandez de Elche"
}
],
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"name": "Hospital Regional Universitario de Málaga: Hospital Regional Universitario de Malaga"
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"family": "Pérez-Belmonte",
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{
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"name": "Hospital Juan Ramón Jiménez: Hospital Juan Ramon Jimenez"
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],
"family": "Carrasco-Sánchez",
"given": "Francisco Javier",
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{
"affiliation": [
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"name": "Hospital Regional Universitario de Málaga: Hospital Regional Universitario de Malaga"
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],
"family": "Jansen-Chaparro",
"given": "Sergio",
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},
{
"affiliation": [
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"name": "Hospital Juan Ramón Jiménez: Hospital Juan Ramon Jimenez"
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],
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"given": "Mercedes",
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{
"affiliation": [
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"name": "Hospital Regional Universitario de Málaga: Hospital Regional Universitario de Malaga"
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],
"family": "Bueno-Fonseca",
"given": "José",
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"affiliation": [
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"name": "Hospital Juan Ramón Jiménez: Hospital Juan Ramon Jimenez"
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],
"family": "Pérez-Aguilar",
"given": "Maria",
"sequence": "additional"
},
{
"affiliation": [
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"name": "Hospital 12 de Octubre Servicio de Medicina Interna"
}
],
"family": "Cañas",
"given": "Coral Arévalo",
"sequence": "additional"
},
{
"affiliation": [
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"name": "Hospital General Universitario Gregorio Marañón: Hospital General Universitario Gregorio Maranon"
}
],
"family": "Cebrian",
"given": "Marta Bacete",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "San Carlos University Hospital Internal Medicine III Service: Hospital Clinico Universitario San Carlos Servicio de Medicina Interna III"
}
],
"family": "Méndez-Bailón",
"given": "Manuel",
"sequence": "additional"
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"name": "Royo Villanova Hospital: Hospital Royo Villanova"
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],
"family": "Mera",
"given": "Isabel Fiteni",
"sequence": "additional"
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{
"affiliation": [
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"name": "Hospital Ramon y Cajal: Hospital Universitario Ramon y Cajal"
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],
"family": "García",
"given": "Andrés González",
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"name": "Hospital Costa del Sol"
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],
"family": "Romero",
"given": "Francisco Navarro",
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"affiliation": [
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"name": ": Complejo Asistencial de Zamora"
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],
"family": "Almeida",
"given": "Carlota Tuñón de",
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"family": "Nicolás",
"given": "Gemma Muñiz",
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"name": "Complejo Hospitalario de Orense: Complexo Hospitalario de Ourense"
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"family": "Noya",
"given": "Amara González",
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"name": "Hospital Universitario Son Espases: Hospital Universitari Son Espases"
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"family": "Milian",
"given": "Almudena Hernández",
"sequence": "additional"
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{
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"name": "Complejo Hospitalario Universitario de Badajoz"
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"given": "Gema María García",
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"affiliation": [
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"name": "VS Hospital"
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"family": "Pedrajas",
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"name": "Hospital Doctor Jose Molina Orosa"
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"name": "Hospital Universitario Rio Hortega"
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"name": "Hospital QuironSalud A Coruña"
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{
"affiliation": [
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"name": "Regional University Hospital of Malaga: Hospital Regional Universitario de Malaga"
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],
"family": "Gómez-Huelgas",
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"title": "Association between prior cardiometabolic therapy and in-hospital mortality in very old patients with type 2 diabetes mellitus hospitalized due to COVID-19. A nationwide observational study in Spain",
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