TY - JOUR
T1 - COVID-19 fatality prediction in people with diabetes and prediabetes using a simple score upon hospital admission
AU - for the COVID-19 in diabetes in Austria study group
AU - Sourij, Harald
AU - Aziz, Faisal
AU - Bräuer, Alexander
AU - Ciardi, Christian
AU - Clodi, Martin
AU - Fasching, Peter
AU - Karolyi, Mario
AU - Kautzky-Willer, Alexandra
AU - Klammer, Carmen
AU - Malle, Oliver
AU - Oulhaj, Abderrahim
AU - Pawelka, Erich
AU - Peric, Slobodan
AU - Ress, Claudia
AU - Sourij, Caren
AU - Stechemesser, Lars
AU - Stingl, Harald
AU - Stulnig, Thomas
AU - Tripolt, Norbert
AU - Wagner, Michael
AU - Wolf, Peter
AU - Zitterl, Andreas
AU - Kaser, Susanne
N1 - Publisher Copyright:
© 2020 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.
PY - 2021/2
Y1 - 2021/2
N2 - 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.
AB - 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.
KW - coronavirus infection, diabetes, prediabetic state
UR - http://www.scopus.com/inward/record.url?scp=85097057528&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85097057528&partnerID=8YFLogxK
U2 - 10.1111/dom.14256
DO - 10.1111/dom.14256
M3 - Article
C2 - 33200501
AN - SCOPUS:85097057528
SN - 1462-8902
VL - 23
SP - 589
EP - 598
JO - Diabetes, Obesity and Metabolism
JF - Diabetes, Obesity and Metabolism
IS - 2
ER -