l'institut du thorax, Inserm, CNRS, UNIV Nantes, CHU Nantes, Nantes, France.
CHU de Nantes, Inserm, CIC 1413, Pôle Hospitalo-Universitaire 11: Santé Publique, Clinique des Données, Nantes, France.
Diabetologia. 2021 Apr;64(4):778-794. doi: 10.1007/s00125-020-05351-w. Epub 2021 Feb 17.
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).
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.
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/m. 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.
Clinicaltrials.gov identifier: NCT04324736.
目的/假设：这是之前 CORONADO（冠状病毒 SARS-CoV-2 和糖尿病结局）研究结果的更新，旨在描述因 2019 年冠状病毒病（COVID-19）住院的糖尿病患者的结局和预后因素。
CORONADO 计划是一项法国全国多中心研究，纳入了因 COVID-19 住院的糖尿病患者，随访 28 天。患者于 2020 年 3 月 10 日至 4 月 10 日住院期间接受筛查。我们主要关注 28 天内的出院和死亡情况。
共纳入 2796 名参与者：63.7%为男性，平均年龄 69.7±13.2 岁，中位 BMI（25 至 75 百分位数）为 28.4（25.0 至 32.4）kg/m²。44.2%和 38.6%的参与者分别存在微血管和大血管糖尿病并发症。28 天内，1404 名（50.2%；95%CI，48.3%，52.1%）患者出院，中位住院时间为 9（5-14）天，577 名患者死亡（20.6%；95%CI，19.2%，22.2%）。多变量模型显示，年龄较小、常规使用二甲双胍治疗和入院时症状持续时间较长与出院相关。微血管并发症史、常规抗凝治疗、入院时呼吸困难以及天冬氨酸转氨酶、白细胞计数和 C 反应蛋白水平较高与出院机会降低相关。与 28 天内死亡相关的因素与出院相关的因素相似，还包括胰岛素和他汀类药物的常规治疗等有害因素。
结论/解释：在因 COVID-19 住院的糖尿病患者中，我们确定了与出院和死亡相关的预后因素，这可能有助于临床医生在大流行期间做出决策。
Clinicaltrials.gov 标识符：NCT04324736。
