RESUMEN
INTRODUCTION: Patients with diabetes mellitus admitted to hospital with COVID-19 have poorer outcomes. However, the drivers of poorer outcomes are not fully elucidated. We performed detailed characterization of patients with COVID-19 to determine the clinical and biochemical factors that may be drivers of poorer outcomes. RESEARCH DESIGN AND METHODS: This is a retrospective cohort study of 889 consecutive inpatients diagnosed with COVID-19 between March 9 and April 22, 2020 in a large London National Health Service Trust. Unbiased multivariate logistic regression analysis was performed to determine variables that were independently and significantly associated with increased risk of death and/or intensive care unit (ICU) admission within 30 days of COVID-19 diagnosis. RESULTS: 62% of patients in our cohort were of non-white ethnic background and the prevalence of diabetes was 38%. 323 (36%) patients met the primary outcome of death/admission to the ICU within 30 days of COVID-19 diagnosis. Male gender, lower platelet count, advancing age and higher Clinical Frailty Scale (CFS) score (but not diabetes) independently predicted poor outcomes on multivariate analysis. Antiplatelet medication was associated with a lower risk of death/ICU admission. Factors that were significantly and independently associated with poorer outcomes in patients with diabetes were coexisting ischemic heart disease, increasing age and lower platelet count. CONCLUSIONS: In this large study of a diverse patient population, comorbidity (ie, diabetes with ischemic heart disease; increasing CFS score in older patients) was a major determinant of poor outcomes with COVID-19. Antiplatelet medication should be evaluated in randomized clinical trials among high-risk patient groups.
Asunto(s)
COVID-19/epidemiología , Diabetes Mellitus/epidemiología , Fragilidad/diagnóstico , Unidades de Cuidados Intensivos/estadística & datos numéricos , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , COVID-19/terapia , Comorbilidad , Diabetes Mellitus/terapia , Femenino , Fragilidad/epidemiología , Hospitales de Enseñanza , Humanos , Modelos Logísticos , Londres/epidemiología , Masculino , Persona de Mediana Edad , Análisis Multivariante , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales , Tasa de Supervivencia , Adulto JovenRESUMEN
Statistical data on the frequency of skin conditions in the Pomeranian region of Poland are limited in the field of pediatric dermatology, requiring a multidisciplinary approach to each patient. Dermatitis and skin allergies are the 10 most common pediatric conditions, with a prevalence of 20% among such chronic illnesses in developed countries. This analysis is limited to the recurrence of dermatologic diseases in the hospitalized pediatric population within the Pomeranian region for the purpose of future targeted education. Retrospective analysis included 282 participants over a 3-year period between 2013 and 2015, with admissions to the Department of Dermatology, Venereology, and Allergology at the Medical University of Gdansk. Diagnoses were obtained from the ward admission book and CliniNet database.