Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort study
| Autor: | Susana Plaza Canteli, Sara Fuente Cosío, Iris El Attar Acedo, Francisco Fuentes-Jiménez, Pablo Perez-Martinez, Lucía Jorge Huerta, Marcos Guzmán Garcia, Jaime Alonso Muñoz, Carlos Jorge Ripper, M. Mar. Ayala-Gutiérrez, Manuel Rubio-Rivas, Jose Javier Napal Lecumberri, José Manuel Ramos-Rincón, Jose D Torres-Peña, Ruth Gonzalez Ferrer, Joaquim Fernández Sola, Ricardo Gómez-Huelgas, Beatriz Vicente Montes, Begoña Cortés Rodríguez, Javier Ena, Luis M. Pérez-Belmonte, Manel Madrazo, Carmen Mella Pérez, Francisco Amorós Martínez, María D. López-Carmona |
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| Rok vydání: | 2020 |
| Předmět: |
Male
lcsh:Medicine 030204 cardiovascular system & hematology law.invention Cohort Studies 0302 clinical medicine law Coronavirus disease 2019 Insulin Hospital Mortality Prospective Studies puntuación de propensión Prospective cohort study diabetes mellitus tipo II glucosa Aged 80 and over Diabetis Diabetes General Medicine Intensive care unit Metformin Hospitalization Intensive Care Units Cohort Drug Therapy Combination Female Coronavirus Infections infecciones por Coronavirus Research Article Cohort study medicine.drug medicine.medical_specialty Pneumonia Viral neumonía vírica 030209 endocrinology & metabolism Betacoronavirus 03 medical and health sciences Sodium-Glucose Transporter 2 Internal medicine Diabetes mellitus Type 2 diabetes mellitus medicine Mortalitat Humans Hypoglycemic Agents insulina transportador 2 de sodio-glucosa Mortality Propensity Score Glucose-lowering drug Pandemics Sodium-Glucose Transporter 2 Inhibitors Aged Dipeptidyl-Peptidase IV Inhibitors Noninvasive Ventilation metformina SARS-CoV-2 respiración artificial business.industry lcsh:R Type 2 Diabetes Mellitus COVID-19 Length of Stay medicine.disease Respiration Artificial Logistic Models Glucose Diabetes Mellitus Type 2 hipoglicemiantes Spain Propensity score matching business |
| Zdroj: | Dipòsit Digital de la UB Universidad de Barcelona BMC MEDICINE r-FISABIO. Repositorio Institucional de Producción Científica INIA: Repositorio de Resultados de Investigación del INIA RUNA. Repositorio da Consellería de Sanidade e Sergas Servizo Galego de Saúde (SERGAS) BMC Medicine r-FISABIO: Repositorio Institucional de Producción Científica Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante instname BMC Medicine, Vol 18, Iss 1, Pp 1-10 (2020) |
| ISSN: | 1741-7015 |
| Popis: | BackgroundLimited evidence exists on the role of glucose-lowering drugs in patients with COVID-19. Our main objective was to examine the association between in-hospital death and each routine at-home glucose-lowering drug both individually and in combination with metformin in patients with type 2 diabetes mellitus admitted for COVID-19. We also evaluated their association with the composite outcome of the need for ICU admission, invasive and non-invasive mechanical ventilation, or in-hospital death as well as on the development of in-hospital complications and a long-time hospital stay.MethodsWe selected all patients with type 2 diabetes mellitus in the Spanish Society of Internal Medicine’s registry of COVID-19 patients (SEMI-COVID-19 Registry). It is an ongoing, observational, multicenter, nationwide cohort of patients admitted for COVID-19 in Spain from March 1, 2020. Each glucose-lowering drug user was matched with a user of other glucose-lowering drugs in a 1:1 manner by propensity scores. In order to assess the adequacy of propensity score matching, we used the standardized mean difference found in patient characteristics after matching. There was considered to be a significant imbalance in the group if a standardized mean difference > 10% was found. To evaluate the association between treatment and study outcomes, both conditional logit and mixed effect logistic regressions were used when the sample size was ≥ 100.ResultsA total of 2666 patients were found in the SEMI-COVID-19 Registry, 1297 on glucose-lowering drugs in monotherapy and 465 in combination with metformin. After propensity matching, 249 patients on metformin, 105 on dipeptidyl peptidase-4 inhibitors, 129 on insulin, 127 on metformin/dipeptidyl peptidase-4 inhibitors, 34 on metformin/sodium-glucose cotransporter 2 inhibitor, and 67 on metformin/insulin were selected. No at-home glucose-lowering drugs showed a significant association with in-hospital death; the composite outcome of the need of intensive care unit admission, mechanical ventilation, or in-hospital death; in-hospital complications; or long-time hospital stays.ConclusionsIn patients with type 2 diabetes mellitus admitted for COVID-19, at-home glucose-lowering drugs showed no significant association with mortality and adverse outcomes. Given the close relationship between diabetes and COVID-19 and the limited evidence on the role of glucose-lowering drugs, prospective studies are needed. |
| Databáze: | OpenAIRE |
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