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COVID-19 fatality prediction in people with diabetes and prediabetes using a simple score upon hospital admission #MMPMID33200501
Sourij H; Aziz F; Brauer A; Ciardi C; Clodi M; Fasching P; Karolyi M; Kautzky-Willer A; Klammer C; Malle O; Oulhaj A; Pawelka E; Peric S; Ress C; Sourij C; Stechemesser L; Stingl H; Stulnig T; Tripolt N; Wagner M; Wolf P; Zitterl A; Kaser S
Diabetes Obes Metab 2021[Feb]; 23 (2): 589-598 PMID33200501show ga
AIM: To assess predictors of in-hospital mortality in people with prediabetes and diabetes hospitalized for COVID-19 infection and to develop a risk score for identifying those at the greatest risk of a fatal outcome. MATERIALS AND METHODS: A combined prospective and retrospective, multicentre, cohort study was conducted at 10 sites in Austria in 247 people with diabetes or newly diagnosed prediabetes who were hospitalized with COVID-19. The primary outcome was in-hospital mortality and the predictor variables upon admission included clinical data, co-morbidities of diabetes or laboratory data. Logistic regression analyses were performed to identify significant predictors and to develop a risk score for in-hospital mortality. RESULTS: The mean age of people hospitalized (n = 238) for COVID-19 was 71.1 +/- 12.9 years, 63.6% were males, 75.6% had type 2 diabetes, 4.6% had type 1 diabetes and 19.8% had prediabetes. The mean duration of hospital stay was 18 +/- 16 days, 23.9% required ventilation therapy and 24.4% died in the hospital. The mortality rate in people with diabetes was numerically higher (26.7%) compared with those with prediabetes (14.9%) but without statistical significance (P = .128). A score including age, arterial occlusive disease, C-reactive protein, estimated glomerular filtration rate and aspartate aminotransferase levels at admission predicted in-hospital mortality with a C-statistic of 0.889 (95% CI: 0.837-0.941) and calibration of 1.000 (P = .909). CONCLUSIONS: The in-hospital mortality for COVID-19 was high in people with diabetes but not significantly different to the risk in people with prediabetes. A risk score using five routinely available patient variables showed excellent predictive performance for assessing in-hospital mortality.
|*Health Status Indicators[MESH]
|Aged[MESH]
|Austria[MESH]
|COVID-19/*mortality/virology[MESH]
|Diabetes Mellitus, Type 2/*mortality/virology[MESH]
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Diabetes+Obes+Metab 2021 ; 23 (2): 589-598
