Cardiometabolic multimorbidity is associated with a worse Covid-19 prognosis than individual cardiometabolic risk factors: a multicentre retrospective study (CoViDiab II)

Autor: Maddaloni, E., D'Onofrio, L., Alessandri, F., Mignogna, C., Leto, G., Pascarella, G., Mezzaroma, I., Lichtner, M., Pozzilli, P., Agro, F. E., Rocco, M., Pugliese, F., Lenzi, A., Holman, R. R., Mastroianni, C. M., Buzzetti, R., Ajassa, C., Alban, R., Alessi, F., Aronica, R., Belvisi, V., Candy, M., Caputi, A., Carrara, A., Casali, E., Cavallari, E. N., Ceccarelli, G., Celani, L., Ciardi, M. R., Coraggio, L., Curtolo, A., D'Agostino, C., D'Ettorre, G., De Giorgi, F., De Girolamo, G., Filippi, V., Gnessi, L., Luordi, C., Moretti, C., Recchia, G., Ridolfi, M., Romani, F. E., Russo, G., Ruberto, F., Savelloni, G., Siccardi, G., Siena, A., Sterpetti, S., Valeri, S., Vera, M., Volpicelli, L., Watanabe, M., Aiuti, M., Campagna, G., Del Borgo, C., Fondaco, L., Kertusha, B., Leonetti, F., Marocco, R., Masala, R., Zuccala, P., Nonnis, G., Rigoli, A., Strumia, A., Alampi, D.
Jazyk: angličtina
Rok vydání: 2020
Předmět:
lcsh:Diseases of the circulatory (Cardiovascular) system
medicine.medical_specialty
multimorbidity
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Pneumonia
Viral
pandemics
Logistic regression
metabolic diseases
law.invention
coronavirus infections
male
law
Diabetes mellitus
Internal medicine
middle aged
medicine
80 and over
copd
covid-19
diabetes
hypertension
sars-cov-2
aged
cardiovascular diseases
diabetes mellitus
female
follow-up studies
humans
pneumonia
viral
prognosis
retrospective studies
risk factors
betacoronavirus
COPD
Original Investigation
Aged
80 and over
Mechanical ventilation
business.industry
SARS-CoV-2
Confounding
Diabetes
Retrospective cohort study
Odds ratio
medicine.disease
Intensive care unit
lcsh:RC666-701
Hypertension
Cardiology and Cardiovascular Medicine
business
Covid-19
Zdroj: Cardiovascular Diabetology
Cardiovascular Diabetology, Vol 19, Iss 1, Pp 1-11 (2020)
ISSN: 1475-2840
Popis: Background Cardiometabolic disorders may worsen Covid-19 outcomes. We investigated features and Covid-19 outcomes for patients with or without diabetes, and with or without cardiometabolic multimorbidity. Methods We collected and compared data retrospectively from patients hospitalized for Covid-19 with and without diabetes, and with and without cardiometabolic multimorbidity (defined as ≥ two of three risk factors of diabetes, hypertension or dyslipidaemia). Multivariate logistic regression was used to assess the risk of the primary composite outcome (any of mechanical ventilation, admission to an intensive care unit [ICU] or death) in patients with diabetes and in those with cardiometabolic multimorbidity, adjusting for confounders. Results Of 354 patients enrolled, those with diabetes (n = 81), compared with those without diabetes (n = 273), had characteristics associated with the primary composite outcome that included older age, higher prevalence of hypertension and chronic obstructive pulmonary disease (COPD), higher levels of inflammatory markers and a lower PaO2/FIO2 ratio. The risk of the primary composite outcome in the 277 patients who completed the study as of May 15th, 2020, was higher in those with diabetes (Adjusted Odds Ratio (adjOR) 2.04, 95%CI 1.12–3.73, p = 0.020), hypertension (adjOR 2.31, 95%CI: 1.37–3.92, p = 0.002) and COPD (adjOR 2.67, 95%CI 1.23–5.80, p = 0.013). Patients with cardiometabolic multimorbidity were at higher risk compared to patients with no cardiometabolic conditions (adjOR 3.19 95%CI 1.61–6.34, p = 0.001). The risk for patients with a single cardiometabolic risk factor did not differ with that for patients with no cardiometabolic risk factors (adjOR 1.66, 0.90–3.06, adjp = 0.10). Conclusions Patients with diabetes hospitalized for Covid-19 present with high-risk features. They are at increased risk of adverse outcomes, likely because diabetes clusters with other cardiometabolic conditions.
Databáze: OpenAIRE
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