학술논문
The association between macrovascular complications and intensive care admission, invasive mechanical ventilation, and mortality in people with diabetes hospitalized for coronavirus disease-2019 (COVID-19)
Document Type
Academic Journal
Author
Llauradó, Gemma; Vlacho, Bogdan; Wargny, Matthieu; Ruan, Yue; Franch-Nadal, Josep; Domingo, Pere; Gourdy, Pierre; Saulnier, Pierre-Jean; Hadjadj, Samy; Wild, Sarah H.; Rea, Rustam; Cariou, Bertrand; Khunti, Kamlesh; Mauricio, Dídac; Arroyo, Juan Antonio; Chillarón, Juan-José; Corcoy, Rosa; Güerri, Roberto; Mata-Cases, Manel; Ortega, Emilio; Pichelin, Matthieu; Saignes, Maëva; Saunier, Jeanne; Andaloussi, Selma El; Martin-Gauthier, Joëlle; Rebouilleau, Emily; Roman, Tanguy; Mahot, Pascale; Fournier-Guilloux, Anne-Laure; Mauduit, Nicolas; Corbel, Edith Bigot-; Boureau, Anne-Sophie; De Dekcer, Laure; Ernould, Audrey; Primot, Claire; Seguin, Anne; Joliveau, Marielle; Pouvreau, Sonia; Fournier, Chloé; Thureau, Jeremy; Fonteneau, Edith; Hublain, Pamela; Agasse, Carole; De Kergaradec, Mathilde; Minville, Vincent; Vardon-Bounes, Fanny; Martin-Blondel, Guillaume; Tramunt, Blandine; Turnin, Marie-Christine; Hanaire, Hélène; Mansuy, Jean-Michel; Fabre, Didier; Arhainx, Marie-Blanche; Cazals, Laurent; Combes, Laure; Lami, Emmanuelle; Megarbane, Bruno; Leroy, Pierre; Gautier, Jean-François; Vidal-Trecan, Tiphaine; Riveline, Jean-Pierre; Laplanche, Jean-Louis; Mouly, Stéphane; Potier, Louis; Roussel, Ronan; Taher, Malak; Abouleka, Yawa; Yaker, Fetta; Carlier, Aurelie; Boutten, Anne; Hallot-Feron, Marilyne; Mourah, Fadila; Thivolet, Charles; Blond, Emilie; Rolland, Muriel; Mendez, Josep Verdecho; Alexandre, Marine; Pottecher, Julien; Richer, Emilie; Meyer, Laurent; Luca, Florina; Lessinger, Jean-Marc; Bahougne, Thibault; Guerci, Bruno; Benzirar, Siham; Malaplate, Catherine; Matton, Thierry; Poissy, Julien; Faure, Karine; Fontaine, Pierre; Baudoux, Florence; Vambergue, Anne; Pekar, Jean David; Lambert, Marc; Yelnik, Cécile; Bruandet, Amélie; Petit, Laurent; Neau, Didier; Rigalleau, Vincent; Berard, Annie; Galioot, Amandine; Coudroy, Remy; Thille, Arnaud; Robert, René; Roblot-Cazenave, France; Rammaert, Blandine; Saulnier, Pierre Jean; Piguel, Xavier; Benhenda, Nesrine; Husson, Camille; Olivier, Celine; Torremocha, Florence; Fraty, Mathilde; D'assigny, Marie Flamen; Miot, Aurelie; Bossard, Valentin; Klouche, Kada; Makinson, Alain; Sultan, Ariane; Bonnet, Jean-Baptiste; Foulongne, Vincent; Galtier, Florence; Aubron, Cécile; Ansart, Séverine; Kerlan, Véronique; Quiniou, Pascale; Carre, Jean- Luc; Quesnot, Stéphane; Laviolle, Bruno; Schwebel, Carole; Epaulard, Olivier; Benhamou, Pierre-Yves; Betry, Cécile; Borel, Anne-Laure; Lablanche, Sandrine; Guergour, Dorra; Duclos, Catherine; Cosson, Emmanuel; Guyot, Erwan; Deniau, Aurore; Nguyen, Phucthutrang; Reznik, Yves; Joubert, Michael; Allouche, Stéphane; Guittet, Lydia; Grange, Steven; Etienne, Manuel; Prévost, Gaëtan; Brunel, Valéry; Lagier, Jean-Christophe; Raoult, Didier; Dutour, Anne; Gaborit, Bénédicte; Boulllu, Sandrine; Darmon, Patrice; Lasbleiz, Adèle; Cerino, Mathieu; Romain, Fanny; Houssays, Marie; Quenot, Jean Pierre; Piroth, Lionel; Vergès, Bruno; Duvillard, Laurence; Bonnotte, Bernard; Mercat, Alain; Dubee, Vincent; Allix, Ingrid; Rodien, Patrice; Dhersin, Robin; Lebeault, Maylis; Trzepizur, Wojciech; Loison, Jocelyne; Brangier, Antoine; Asfar, Pierre; Reynier, Pascal; Larcher, Françoise; Joubaud, Françoise; Andreu, Marie-Rita; Urbanski, Geoffrey; Hubert, Laurent; Annweiler, Cedric; Dellamonica, Jean; Courjon, Johan; Chevalier, Nicolas; Chinetti, Giulia; Chafai, Magda; Mourvillier, Bruno; Bani-Sadr, Firouze; Barraud, Sarra; Delemer, Brigitte; Gillery, Philippe; Labedade, Pascale; Chabrol, Amélie; Penfornis, Alfred; Petit, Catherine; Amadou, Coralie; Adler, Maxime; Dubost, Clément; Conan, Pierre-Louis; Bordier, Lyse; Ceppa, Franck; Garcia, Cyril; Sollier, Mathilde; Dupuy, Olivier; Laplance, Sophie; Billuart, Olivier; Aroulanda, Marie Joseph; Olivier, Frédérique; Ayon, Florence; Wilhelm, Nathalie; Epelboin, Loic; Sabbah, Nadia; Charpin, Aurelie; Squara, Pierre; Belliard, Olivier; Dubois, Claude; Marre, Michel; Auchabie, Johann; Courtois, Roxane; Duriez, Thierry; Mergey, Tiphaine; Vallee, Laura; Seguin, Laetitia; Al-Salameh, Abdallah; Lanoix, Jean-Philippe; Soriot-Thomas, Sandrine; Bourgeois-Descouls, Anne-Marie; Desailloud, Rachel; Germain, Natacha; Galusca, Bogdan; Belleton, Gwenaelle; Marouani, Nesrine; Palaghiu, Delia; Hammour, Amira; Berdaguer, Fernando; Klopfenstein, Thimothée; Zayet, Hajer; Winiszewski, Patrice; Zanusso, Marie; Garnier, Pauline; Julier, Ingrid; Hamzaoui, Karim; Marty-Gres, Sophie; Sadki, Tarik El; Cadot, Lucile; Dubost, Jean-Louis; Gonfroy, Céline; Campinos, Catherine; Martres, Pascale; Coulhon, Marie Pierre; Allou, Nicolas; Bachir, Marwa; Hoang, Stella; Kembellec, Candice; Suply, Olivia; Kharcha, Fatima; Devouge, Anne-Claire; Flaus-Furmanuk, Anna; Madeline, Isabelle; Ehinger, Vincent; Bastard, Sophie; Raffray, Loic; Renou, Frederic; Bojarsk, Aude; Borsu, Karine; Gorlin, Angelique; Di Bernardo, Servane; Van Ut, Carole Truong; Renaud, Stephane; Vignoles, Antoine; Foch, Emilie; Masse, Laurie; Grand, Hubert; Ferrand, Helene; Raffaitin-Cardin, Christelle; Zellagui, Hadjer; Castang-Brachet, Celine; Boury, Frederique; Tena, Ana Alvarez; Moura, Isabelle; Kalfon, Pierre; Pasteur, Louis; Darasteanu, Juliana; Monier, Arnaud; Foucault, Pascal; Depuille, Alexandra; Laugier-Robiolle, Stéphanie; Caneiro, Patrick; Basso, Maud; Larger, Etienne; Bouam, Samir; Benzenati, Wahiba; Bachir, Leila Ait; Pillegand, Camille Cussac; Vasse, Marc; Michard, Christophe; Montanier, Nathanaëlle; Millot, Luc; Crepet, Françoise; Ratsimba, Danielle; Bouiller, Kevin; Borot, Sophie; Bruckert, Isabelle; Clergeot, Annie; Schillo, Franck; Vignes, Dorothée; Bourgeon-GhittoriLachgar, Muriel; De Cursay, Claire Lambert; Levante, Stéphane; Auregan, Jean Charles; Merlet, Antoine; Zaragoza, Cécile; Arnault, Gwénaëlle; Le Loupp, Anne-Gaëlle; Lesieur, Olivier; Roncato-Saberan, Mariam; Gouet, Didier; Lemari, Romain; Allano, Hong-An; Vivier, Emmanuel; Pariset, Caroline; Luyton, Cédric; Marchand, Lucien; Doroszewski, Fanny; Pecquet, Matthieu; Perard, Laurent; Vuillermoz-Blas, Sylvie; Kacki, Nicolas; Charrier, Patricia; Ducet-Boiffard, Amélie; Du Roure, Françoise Desroys; Bourron, Olivier; Bonnefont-Rousselot, Dominique; Laroche, Suzanne; Phan, Franck; Hartemann, Agnès; Caussy, Cyrielle; Disse, Emmanuel; Guerin, Claude; Perpoint, Thomas; Moulin, Philippe; Cartier, Régine; Hariri, Geoffroy; Chopin, Dorothée; Vatier, Camille; Bourcigaux, Nathalie; Chaigneau, Emmanuelle; Christin-Maitre, Sophie; Donadille, Bruno; Feve, Bruno; Lamothe, Sophie; Sarfati, Julie; Pernet, Pascal; Chambon, Anne; Demarsy, Delphine; Campagne, Hugo; Latil-Plat, Françoise; Berne, Monica; Grinand, Marilyne; Touzet, Marion; Zabulon, Aydrey; Craspag, Jocelyne; Ledoux, Catherine; Contaret, Cedric; Janand-Delenne, Blandine; Giraud, Anaïs; Lacrimini, Marie Lou; Arrivie, Joëlle; Ancelle, Deborah; Guillois, Carine; Fremy, Bénédicte; Chaalal, Amina; Barrande, Gaëlle; Dorange, Anne; Rouanet, Eglantine; Seret-Begue, Dominique; Saoud, Audrey; Guedj, Anne-Marie; Bedos, Nathalie; Velayoudom, Fritz-Line; Dumas, Marie; Gonda, Benoite; Coffin, Christine; Gibiat, Stéphanie; Lungo, Myriam; Bully, Chantal; Serusclat, Pierre; Bully, Stella; Carre, Patricia; Leberre, Jean-Philippe; Elkhoury, Carlos; Thieux, Marine; Paradisi-Prieur, Laetitia; Wilmot, Emma; Wild, Sarah; Field, Ben; Narendran, Parth; Gandhi, Rajiv; Harris, Sophie; Nagi, Dinesh; Ryder, Robert; Davies, Jim; Harris, Steve; Freeman, Oliver; Maylor, Ben; Várnai, Kinga A.; Roadknight, Gail; Cul, Melissa; Edwards, Amy; Gelding, Susan; Gunganah, Kirun; Aung, Pyei; Banerjee, Moulinath; Chakera, Ali; Rouse, Dominique; Ahmed, Syed Haris; Cheung, Ho Yee; Roberts, Hywel; Seal, Susan; Shah, Syed Saah; Hayat, Amir; Mohandas, Cynthia; Aung, Htet Htet; Chel, Su Khant; Lin, Nyan; Narula, Kavitia; Quadri, Furruq; Yin, Su Lei; Yin, Yin; Alkundi, Alamin; Musa, Abdelmajid; Birbeck, Emma; Bodmer, Charles; Bossman, Irene; Kumar, Sathis; Dashora, Umesh; Toubi, Elizabeth; Zafar, Mansoor; Patel, Vinod; Gopinath, Amitha; Allan, Belinda; Karim, Remat; Appuhamillage, Dharshana; Ayoub, Khubaib; Ilangaratne, Charmaine; Iqbal, Maliha; Maclean, Rory; Mustafa, Omar; Baxter, Susan; Adamus, Malgorzata; Baynes, Kevin; Sivappriyan, Siva; D'Costa, Ryan; Parfitt, Vernon; Islam, Mazharul; Nasir, Sadia; Várnai, Kinga; Vasan, Senthil; Devah, Vilashini Arul; Kavvoura, Foteini; Ficken, Lina; Gilham, James; Simpson, Vincent; Walker, Neil; Aziz, Umaira; Karra, Efthimia; Patel, Dipesh; Rosenthal, Miranda; Curran, Tracy; Paisley, Angela; Cull, Melissa; De P, Parijat; Khine, May Thin; Qayyam, Pari; Sarkar, Priscilla; Clark, James; Hogan, Vesna; Jackson, Lauren; Williamson, Jamie-Leigh; Younes, R.; Robin, Lucy; Grixti, Lydia; Tee, Suann; Sathya, Abilash; Patel, Mayank; Holmes, Catherine; Hanif, Wasim; Ghosh, Sandip; Ahmad, Ehtasham; Ahmed, Ejaz; Davies, Melanie; Hartshorn, Steven; Simons, Lee; Webb, David; Brahma, Anupam; Pramodh, Seshadri; Frew, Katy; Mackenzie, Alison; Wild, Abigail; Casey, Helen; Morrison, Deborah; McKeag, Conor; Sillars, Anne; Stirling, Angus; Smeeton, Fiona; Muhammad, Syed; Obuobie, Kofi; Yin, Win; Agarwal, Neera; Atkinson, Mike; Ambati, Sai; Khan, Rahim; Nalla, Preethi; Tabasum, Arshiya; Zouras, Stamatios; Mallipedhi, Akhila; Chudleigh, Richard; Williams, David; Cianferani, Mallory; Ludwig, Lisa; Paul, Caroline; Lachgar, Hamoud
Source
Cardiovascular Diabetology. October 19, 2022, Vol. 21 Issue 1
Subject
Language
English
Abstract
Author(s): Gemma Llauradó[sup.1,2], Bogdan Vlacho[sup.3,4], Matthieu Wargny[sup.5,6], Yue Ruan[sup.7,8], Josep Franch-Nadal[sup.2,3,9], Pere Domingo[sup.10], Pierre Gourdy[sup.11], Pierre-Jean Saulnier[sup.12], Samy Hadjadj[sup.5], Sarah H. Wild[sup.13], Rustam Rea[sup.7,8], Bertrand Cariou[sup.5], Kamlesh Khunti[sup.14], Dídac Mauricio[sup.2,15], [...]
Background It is not clear whether pre-existing macrovascular complications (ischemic heart disease, stroke or peripheral artery disease) are associated with health outcomes in people with diabetes mellitus hospitalized for COVID-19. Methods We conducted cohort studies of adults with pre-existing diabetes hospitalized for COVID-19 infection in the UK, France, and Spain during the early phase of the pandemic (between March 2020--October 2020). Logistic regression models adjusted for demographic factors and other comorbidities were used to determine associations between previous macrovascular disease and relevant clinical outcomes: mortality, intensive care unit (ICU) admission and use of invasive mechanical ventilation (IMV) during the hospitalization. Output from individual logistic regression models for each cohort was combined in a meta-analysis. Results Complete data were available for 4,106 (60.4%) individuals. Of these, 1,652 (40.2%) had any prior macrovascular disease of whom 28.5% of patients died. Mortality was higher for people with compared to those without previous macrovascular disease (37.7% vs 22.4%). The combined crude odds ratio (OR) for previous macrovascular disease and mortality for all four cohorts was 2.12 (95% CI 1.83-2.45 with an I.sup.2 of 60%, reduced after adjustments for age, sex, type of diabetes, hypertension, microvascular disease, ethnicity, and BMI to adjusted OR 1.53 [95% CI 1.29-1.81]) for the three cohorts. Further analysis revealed that ischemic heart disease and cerebrovascular disease were the main contributors of adverse outcomes. However, proportions of people admitted to ICU (adjOR 0.48 [95% CI 0.31-0.75], I.sup.2 60%) and the use of IMV during hospitalization (adjOR 0.52 [95% CI 0.40-0.68], I.sup.2 37%) were significantly lower for people with previous macrovascular disease. Conclusions This large multinational study of people with diabetes mellitus hospitalized for COVID-19 demonstrates that previous macrovascular disease is associated with higher mortality and lower proportions admitted to ICU and treated with IMV during hospitalization suggesting selective admission criteria. Our findings highlight the importance correctly assess the prognosis and intensive monitoring in this high-risk group of patients and emphasize the need to design specific public health programs aimed to prevent SARS-CoV-2 infection in this subgroup. Keywords: Diabetes, Macrovascular disease, Mortality, COVID-19
Background It is not clear whether pre-existing macrovascular complications (ischemic heart disease, stroke or peripheral artery disease) are associated with health outcomes in people with diabetes mellitus hospitalized for COVID-19. Methods We conducted cohort studies of adults with pre-existing diabetes hospitalized for COVID-19 infection in the UK, France, and Spain during the early phase of the pandemic (between March 2020--October 2020). Logistic regression models adjusted for demographic factors and other comorbidities were used to determine associations between previous macrovascular disease and relevant clinical outcomes: mortality, intensive care unit (ICU) admission and use of invasive mechanical ventilation (IMV) during the hospitalization. Output from individual logistic regression models for each cohort was combined in a meta-analysis. Results Complete data were available for 4,106 (60.4%) individuals. Of these, 1,652 (40.2%) had any prior macrovascular disease of whom 28.5% of patients died. Mortality was higher for people with compared to those without previous macrovascular disease (37.7% vs 22.4%). The combined crude odds ratio (OR) for previous macrovascular disease and mortality for all four cohorts was 2.12 (95% CI 1.83-2.45 with an I.sup.2 of 60%, reduced after adjustments for age, sex, type of diabetes, hypertension, microvascular disease, ethnicity, and BMI to adjusted OR 1.53 [95% CI 1.29-1.81]) for the three cohorts. Further analysis revealed that ischemic heart disease and cerebrovascular disease were the main contributors of adverse outcomes. However, proportions of people admitted to ICU (adjOR 0.48 [95% CI 0.31-0.75], I.sup.2 60%) and the use of IMV during hospitalization (adjOR 0.52 [95% CI 0.40-0.68], I.sup.2 37%) were significantly lower for people with previous macrovascular disease. Conclusions This large multinational study of people with diabetes mellitus hospitalized for COVID-19 demonstrates that previous macrovascular disease is associated with higher mortality and lower proportions admitted to ICU and treated with IMV during hospitalization suggesting selective admission criteria. Our findings highlight the importance correctly assess the prognosis and intensive monitoring in this high-risk group of patients and emphasize the need to design specific public health programs aimed to prevent SARS-CoV-2 infection in this subgroup. Keywords: Diabetes, Macrovascular disease, Mortality, COVID-19