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

Cardiovascular Diabetology

Felice Eugenio Agrò¹  Paolo Pozzilli¹  Giuseppe Pascarella¹  Rury R. Holman²  Gaetano Leto³  Miriam Lichtner³  Monica Rocco⁴  Ivano Mezzaroma⁵  Claudio Maria Mastroianni⁵  Raffaella Buzzetti⁵  Luca D’Onofrio⁵  Francesco Pugliese⁵  Andrea Lenzi⁵  Carmen Mignogna⁵  Francesco Alessandri⁵  Ernesto Maddaloni⁶ 

[1] Campus Bio-Medico University of Rome, Rome, Italy;Diabetes Trial Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, UK;Santa Maria Goretti Hospital, Polo Pontino Sapienza University, Latina, Italy;Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy;Umberto I “Policlinico” General Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy;Umberto I “Policlinico” General Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy;Diabetes Trial Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, UK;

关键词: Covid-19;    Diabetes;    SARS-CoV-2;    Hypertension;    COPD;   

DOI  :  10.1186/s12933-020-01140-2

来源: Springer

【 摘 要 】

BackgroundCardiometabolic 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.MethodsWe 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.ResultsOf 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).ConclusionsPatients 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.

【 授权许可】

CC BY