Cardiometabolic Therapy and Mortality in Very Old Patients With Diabetes Hospitalized due to COVID-19.

Autor:	Ramos-Rincón JM; Department of Clinical Medicine, Miguel Hernandez University of Elche, Alicante, Spain., Pérez-Belmonte LM; Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), Spain., Carrasco-Sánchez FJ; Internal Medicine Department, Juan Ramón Jiménez University Hospital, Huelva, Spain., Jansen-Chaparro S; Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), Spain., De-Sousa-Baena M; Internal Medicine Department, Juan Ramón Jiménez University Hospital, Huelva, Spain., Bueno-Fonseca J; Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), Spain., Pérez-Aguilar M; Internal Medicine Department, Juan Ramón Jiménez University Hospital, Huelva, Spain., Arévalo-Cañas C; Internal Medicine Department, 12 de Octubre University Hospital, Madrid, Spain., Bacete Cebrian M; Internal Medicine Department, Gregorio Marañon University Hospital, Madrid, Spain., Méndez-Bailón M; Internal Medicine Department, San Carlos Clinical Hospital, Complutense University, Madrid, Spain., Fiteni Mera I; Internal Medicine Department, Royo Villanova Hospital, Zaragoza, Spain., González García A; Internal Medicine Department, Ramón y Cajal University Hospital, Madrid, Spain., Navarro Romero F; Internal Medicine Department, Costa del Sol Hospital, Marbella, Spain., Tuñón de Almeida C; Internal Medicine Department, Zamora Hospital Complex, Spain., Muñiz Nicolás G; Internal Medicine Department, Virgen de la Salud Hospital, Toledo, Spain., González Noya A; Internal Medicine Department, Ourense University Hospital Complex, Spain., Hernández Milian A; Internal Medicine Department, Son Llàtzer University Hospital, Palma de Mallorca, Spain., García García GM; Internal Medicine Department, Badajoz University Hospital Complex, Spain., Alcalá Pedrajas JN; Internal Medicine Department, Pozoblanco Hospital, Spain., Herrero García V; Internal Medicine Department, Doctor José Molina Orosa Hospital, Arrecife, Spain., Corral-Gudino L; Internal Medicine Department, Río Hortega University Hospital, Regional Health Management of Castilla y Leon (SACYL), Valladolid University, Spain., Comas Casanova P; Internal Medicine Department, Blanes Hospital, Spain., Meijide Míguez H; Internal Medicine Department, Quironsalud A Coruña Hospital, Spain., Casas-Rojo JM; Internal Medicine Department, Infanta Cristina University Hospital, Madrid, Spain., Gómez-Huelgas R; Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), Spain.
Jazyk:	angličtina
Zdroj:	The journals of gerontology. Series A, Biological sciences and medical sciences [J Gerontol A Biol Sci Med Sci] 2021 Jul 13; Vol. 76 (8), pp. e102-e109.
DOI:	10.1093/gerona/glab124
Abstrakt:	Background: The effects of cardiometabolic drugs on the prognosis of diabetic patients with COVID-19, especially very old patients, are not well known. This work was aimed to analyze the association between preadmission cardiometabolic therapy (antidiabetic, antiaggregant, antihypertensive, and lipid-lowering drugs) and in-hospital mortality among patients ≥80 years with type 2 diabetes mellitus (T2DM) hospitalized for COVID-19. Method: We conducted a nationwide, multicenter, observational study in patients ≥80 years with T2DM hospitalized for COVID-19 between March 1 and May 29, 2020. The primary outcome measure was in-hospital mortality. A multivariate logistic regression analysis was performed to assess the association between preadmission cardiometabolic therapy and in-hospital mortality. Results: Of the 2 763 patients ≥80 years old hospitalized due to COVID-19, 790 (28.6%) had T2DM. Of these patients, 385 (48.7%) died during admission. On the multivariate analysis, the use of dipeptidyl peptidase-4 inhibitors (adjusted odds ratio [AOR] 0.502, 95% confidence interval [CI]: 0.309-0.815, p = .005) and angiotensin receptor blockers (AOR 0.454, 95% CI: 0.274-0.759, p = .003) were independent protectors against in-hospital mortality, whereas the use of acetylsalicylic acid was associated with higher in-hospital mortality (AOR 1.761, 95% CI: 1.092-2.842, p = .020). Other antidiabetic drugs, angiotensin-converting enzyme inhibitors, and statins showed neutral association with in-hospital mortality. Conclusions: We found important differences between cardiometabolic drugs and in-hospital mortality in older patients with T2DM hospitalized for COVID-19. Preadmission treatment with dipeptidyl peptidase-4 inhibitors and angiotensin receptor blockers could reduce in-hospital mortality; other antidiabetic drugs, angiotensin-converting enzyme inhibitors, and statins seem to have a neutral effect; and acetylsalicylic acid could be associated with excess mortality. (© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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