Association between hyperglycemia treatment and mortality in patients with diabetes and COVID-19 in a Peruvian hospital: A retrospective cohort study

IF 4.2 Q1 ENDOCRINOLOGY & METABOLISM Journal of Clinical and Translational Endocrinology Pub Date : 2021-12-01 DOI:10.1016/j.jcte.2021.100265
Eddy Lopez-Huamanrayme , Dioni D. Garate-Chirinos , Frank Espinoza-Morales , Sharon Del-Castillo-Ochoa , Andrés Gomez-Noronha , Elizabeth Salsavilca-Macavilca , Alvaro Taype-Rondan , Francisco J. Pasquel
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引用次数: 5

Abstract

Objective

To evaluate the association between hyperglycemia treatment and mortality in patients with diabetes and COVID-19 in a Peruvian hospital.

Methods

A retrospective cohort study was conducted between March and July 2020. Individual-level data were extracted from an implemented virtual platform. We included patients with type 2 diabetes hospitalized with COVID-19. The assessed outcome was in-hospital mortality. The Independent variable of interest was hyperglycemic treatment. We used Poisson regressions with robust variance to obtain crude and adjusted relative risks (RR) and their 95% confidence intervals (95% CI).

Results

Out of 1635 patients hospitalized for COVID-19 during the study period, 248 patients with diabetes mellitus were included. The majority were men (66.9%), the median age was 62 years. Ninety-seven patients died in the hospital (39.1%). The median glycemia on admission was 222.5 mg/dL. At 48 h after hospital admission, 125 patients (50.4%) received sliding scale insulin alone (SSI), 46 (18.5%) received a fixed-dose insulin regimen. In the adjusted analysis, the group with SSI at 48 h of hospitalization had higher mortality than those with fixed-dose insulin (adjusted RR: 1.69; 95% CI: 1.01 – 2.83), and those and who continued with SSI in the following days had higher mortality compared to the group that switched to fixed-dose insulin (adjusted RR: 1.64; 95% CI: 1.17 – 2.32).

Conclusion

Among assessed patients with diabetes and COVID-19, more than a third died during hospitalization. Early and continuous use of the sliding scale was associated with higher mortality compared to fixed-dose insulin regimens.

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秘鲁一家医院糖尿病和COVID-19患者高血糖治疗与死亡率之间的关系:一项回顾性队列研究
目的评价秘鲁某医院糖尿病合并COVID-19患者高血糖治疗与死亡率的关系。方法于2020年3月至7月进行回顾性队列研究。从实现的虚拟平台中提取个人层面的数据。我们纳入了因COVID-19住院的2型糖尿病患者。评估结果为住院死亡率。值得关注的自变量是高血糖治疗。我们使用具有稳健方差的泊松回归来获得粗糙和调整后的相对风险(RR)及其95%置信区间(95% CI)。结果在研究期间因COVID-19住院的1635例患者中,包括248例糖尿病患者。男性居多(66.9%),中位年龄62岁。院内死亡97例(39.1%)。入院时血糖中位数为222.5 mg/dL。入院后48小时,125例(50.4%)患者接受单独滑动胰岛素(SSI)治疗,46例(18.5%)患者接受固定剂量胰岛素治疗。在校正分析中,住院48 h时SSI组的死亡率高于固定剂量胰岛素组(校正RR: 1.69;95% CI: 1.01 - 2.83),并且与改用固定剂量胰岛素的组相比,在随后几天继续使用SSI的组死亡率更高(调整后RR: 1.64;95% ci: 1.17 - 2.32)。结论在评估的糖尿病合并COVID-19患者中,超过三分之一的患者在住院期间死亡。与固定剂量胰岛素方案相比,早期和持续使用滑动量表与更高的死亡率相关。
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CiteScore
6.10
自引率
0.00%
发文量
24
审稿时长
16 weeks
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