Fifth of sufferers with Covid-19 and diabetes ‘die inside 28 days of admission’

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Latest data on Covid-19 patients with diabetes show that, according to researchers from France, one in five dies within 28 days of hospitalization.

Updated results from a study analyzing the results of patients with diabetes who were hospitalized with Covid-19 show that while about half were discharged, one in five died within 28 days.

“Identifying favorable variables related to hospital discharge and unfavorable variables related to death can result in patient reclassification.”

Study authors

Last year, preliminary data from the CORONADO study (Coronavirus SARS-CoV-2 and Diabetes Outcomes) showed that 10% of patients with diabetes and Covid-19 died within seven days of admission.

The updated analysis, published this week, included 2,796 participants from 68 centers across France. A mean age of 70 years and a mean body mass index indicated that they were overweight.

According to the authors of the study, microvascular and macrovascular diabetic complications were found in 44% and 39% of the participants, respectively.

Within 28 days, 1,404 (50%) of the patients with a mean hospital stay of nine days were discharged from the hospital, while 577 participants (21%) died.

Of the remaining patients, 12% remained in the hospital on the 28th day, while 17% were transferred to other facilities different from their original hospital.

Computer models showed that various factors such as younger age, routine metformin therapy, and the longer duration of symptoms on admission were associated with a higher probability of discharge.

History of microvascular complications, routine anticoagulation therapy, shortness of breath on admission, abnormal levels of liver enzymes, higher white blood cell counts, and higher levels of the C-reactive protein of the systemic marker of inflammation were all associated with a lower chance of discharge and a higher chance of death.

Patients whose diabetes was regularly treated with insulin – which may indicate more advanced diabetes – had a 44% increased risk of death compared to those who were not treated with insulin.

The researchers highlighted that an unusual finding from the study was a 42% increased risk of death for patients with diabetes who received statin treatment for high cholesterol.

However, since this was an observational study, it was difficult to draw definitive conclusions about a relationship with statins or any other treatment.

The study also found that long-term glycemic control, assessed with HbA1c before or after admission, had no significant association with death or discharge within 28 days.

In contrast, elevated plasma glucose levels upon admission was a strong predictor of death and consistently a lower likelihood of discharge, the researchers found.

The study was led by Professor Bertrand Cariou and Professor Samy Hadjadj, diabetologists at the Institute for Thorax at Nantes University Hospital.

They said, “With regard to death, we reported a death rate of 11.2% in 7 days, which reached 20.6% in 28 days. These results can be compared with international reports.

“Identifying favorable variables associated with discharge from hospital and unfavorable variables associated with death can reclassify the patient and help ensure that resources are used appropriately according to the individual patient profile.

“Our results also establish a link between routine therapy and the likelihood of discharge or risk of death,” they said. “Interestingly, metformin has been associated with favorable results.

“Conversely, the use of statins was associated with a higher risk of death and an anticoagulation therapy with a lower probability of discharge. The results with statins are surprising, ”they added.

The new findings from the CORONADO study will be published in Diabetologia, the journal of the European Association for the Study of Diabetes.