Predictors of hospital discharge and mortality in patients with diabetes and COVID-19: updated results from the nationwide CORONADO study
Retrospective 2,796 hospitalized diabetes patients with COVID-19 in France, showing lower mortality with metformin use.
risk of death, 28.3% lower, RR 0.72, p = 0.03, treatment 247 of 1,553 (15.9%), control 330 of 1,241 (26.6%), NNT 9.4, adjusted per study, odds ratio converted to relative risk, multivariable, day 28.
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risk of no hospital discharge, 14.8% lower, RR 0.85, p = 0.02, treatment 690 of 1,553 (44.4%), control 702 of 1,241 (56.6%), NNT 8.2, adjusted per study, inverted to make RR<1 favor treatment, odds ratio converted to relative risk, multivariable, day 28.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Wargny et al., 17 Feb 2021, retrospective, France, peer-reviewed, 43 authors, study period 10 March, 2020 - 10 April, 2020, trial
NCT04324736 (history) (CORONADO).
Abstract: Diabetologia (2021) 64:778–794
https://doi.org/10.1007/s00125-020-05351-w
ARTICLE
Predictors of hospital discharge and mortality in patients
with diabetes and COVID-19: updated results from the nationwide
CORONADO study
Matthieu Wargny 1,2 & Louis Potier 3,4 & Pierre Gourdy 5,6 & Matthieu Pichelin 1 & Coralie Amadou 7,8 &
Pierre-Yves Benhamou 9,10 & Jean-Baptiste Bonnet 11 & Lyse Bordier 12 & Olivier Bourron 13,14,15,16 & Claude Chaumeil 17 &
Nicolas Chevalier 18 & Patrice Darmon 19,20 & Blandine Delenne 21 & Delphine Demarsy 22 & Marie Dumas 23 &
Olivier Dupuy 24 & Anna Flaus-Furmaniuk 25 & Jean-François Gautier 4,26 & Anne-Marie Guedj 27 &
Nathalie Jeandidier 28 & Etienne Larger 29 & Jean-Philippe Le Berre 30 & Myriam Lungo 31 & Nathanaëlle Montanier 32 &
Philippe Moulin 33 & Françoise Plat 34 & Vincent Rigalleau 35 & René Robert 36 & Dominique Seret-Bégué 37 &
Pierre Sérusclat 38 & Sarra Smati 1 & Jean-François Thébaut 17 & Blandine Tramunt 5,6 & Camille Vatier 39,40 &
Fritz-Line Velayoudom 41 & Bruno Vergès 42 & Patrice Winiszewski 43 & Audrey Zabulon 44 & Pierre-Antoine Gourraud 2 &
Ronan Roussel 3,4 & Bertrand Cariou 1 & Samy Hadjadj 1 & for the CORONADO investigators
Received: 2 September 2020 / Accepted: 10 November 2020 / Published online: 17 February 2021
# The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature 2021
Abstract
Aims/hypothesis This is an update of the results from the previous report of the CORONADO (Coronavirus SARS-CoV-2 and
Diabetes Outcomes) study, which aims to describe the outcomes and prognostic factors in patients with diabetes hospitalised for
coronavirus disease-2019 (COVID-19).
Methods The CORONADO initiative is a French nationwide multicentre study of patients with diabetes hospitalised for
COVID-19 with a 28-day follow-up. The patients were screened after hospital admission from 10 March to 10 April 2020.
We mainly focused on hospital discharge and death within 28 days.
Results We included 2796 participants: 63.7% men, mean age 69.7 ± 13.2 years, median BMI (25th–75th percentile) 28.4 (25.0–32.4)
kg/m2. Microvascular and macrovascular diabetic complications were found in 44.2% and 38.6% of participants, respectively. Within
28 days, 1404 (50.2%; 95% CI 48.3%, 52.1%) were discharged from hospital with a median duration of hospital stay of 9 (5–14) days,
while 577 participants died (20.6%; 95% CI 19.2%, 22.2%). In multivariable models, younger age, routine metformin therapy and
longer symptom duration on admission were positively associated with discharge. History of microvascular complications, anticoagulant
routine therapy, dyspnoea on admission, and higher aspartate aminotransferase, white cell count and C-reactive protein levels were
associated with a reduced chance of discharge. Factors associated with death within 28 days mirrored those associated with discharge,
and also included routine treatment by insulin and statin as deleterious factors.
Conclusions/interpretation In patients with diabetes hospitalised for COVID-19, we established prognostic factors for hospital
discharge and death that could help clinicians in this pandemic period.
Trial registration Clinicaltrials.gov identifier: NCT04324736
Keywords Admission plasma glucose . COVID-19 . Death . Diabetes . Discharge . HbA1c . Home discharge . Mechanical
ventilation
Matthieu Wargny and Louis Potier contributed equally to the manuscript
and must be considered as joint first authors.
Bertrand Cariou and..
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