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A UK nationwide study of adults admitted to hospital with diabetic ketoacidosis or hyperosmolar hyperglycaemic state and COVID-19.
Field, Benjamin C T; Ruan, Yue; Várnai, Kinga A; Davies, Jim; Ryder, Robert E J; Gandhi, Rajiv; Harris, Sophie; Nagi, Dinesh; Patel, Dipesh; Kempegowda, Punith; Wild, Sarah H; Wilmot, Emma G; Khunti, Kamlesh; Rea, Rustam; Narendran, Parth.
Afiliación
  • Field BCT; Department of Clinical & Experimental Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, UK.
  • Ruan Y; Department of Diabetes & Endocrinology, Surrey & Sussex Healthcare NHS Trust, Redhill, UK.
  • Várnai KA; Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Davies J; Oxford NIHR Biomedical Research Centre, Oxford, UK.
  • Ryder REJ; Oxford NIHR Biomedical Research Centre, Oxford, UK.
  • Gandhi R; Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Harris S; Oxford NIHR Biomedical Research Centre, Oxford, UK.
  • Nagi D; Department of Computer Science, University of Oxford, Oxford, UK.
  • Patel D; Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
  • Kempegowda P; Department of Diabetes & Endocrinology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
  • Wild SH; Diabetes Department, King's College Hospital, London, UK.
  • Wilmot EG; Mid Yorkshire Hospitals NHS Trust, Pinderfields Hospital, Wakefield, UK.
  • Khunti K; Royal Free Hospital, London, UK.
  • Rea R; Diabetes Centre, The Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Narendran P; Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Diabetes Obes Metab ; 25(7): 2012-2022, 2023 07.
Article en En | MEDLINE | ID: mdl-37016487
AIMS: To investigate characteristics of people hospitalized with coronavirus-disease-2019 (COVID-19) and diabetic ketoacidosis (DKA) or hyperosmolar hyperglycaemic state (HHS), and to identify risk factors for mortality and intensive care admission. MATERIALS AND METHODS: Retrospective cohort study with anonymized data from the Association of British Clinical Diabetologists nationwide audit of hospital admissions with COVID-19 and diabetes, from start of pandemic to November 2021. The primary outcome was inpatient mortality. DKA and HHS were adjudicated against national criteria. Age-adjusted odds ratios were calculated using logistic regression. RESULTS: In total, 85 confirmed DKA cases, and 20 HHS, occurred among 4073 people (211 type 1 diabetes, 3748 type 2 diabetes, 114 unknown type) hospitalized with COVID-19. Mean (SD) age was 60 (18.2) years in DKA and 74 (11.8) years in HHS (p < .001). A higher proportion of patients with HHS than with DKA were of non-White ethnicity (71.4% vs 39.0% p = .038). Mortality in DKA was 36.8% (n = 57) and 3.8% (n = 26) in type 2 and type 1 diabetes respectively. Among people with type 2 diabetes and DKA, mortality was lower in insulin users compared with non-users [21.4% vs. 52.2%; age-adjusted odds ratio 0.13 (95% CI 0.03-0.60)]. Crude mortality was lower in DKA than HHS (25.9% vs. 65.0%, p = .001) and in statin users versus non-users (36.4% vs. 100%; p = .035) but these were not statistically significant after age adjustment. CONCLUSIONS: Hospitalization with COVID-19 and adjudicated DKA is four times more common than HHS but both associate with substantial mortality. There is a strong association of previous insulin therapy with survival in type 2 diabetes-associated DKA.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cetoacidosis Diabética / Diabetes Mellitus Tipo 1 / Diabetes Mellitus Tipo 2 / COVID-19 / Coma Hiperglucémico Hiperosmolar no Cetósico / Hiperglucemia Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans / Middle aged País/Región como asunto: Europa Idioma: En Revista: Diabetes Obes Metab Asunto de la revista: ENDOCRINOLOGIA / METABOLISMO Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cetoacidosis Diabética / Diabetes Mellitus Tipo 1 / Diabetes Mellitus Tipo 2 / COVID-19 / Coma Hiperglucémico Hiperosmolar no Cetósico / Hiperglucemia Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans / Middle aged País/Región como asunto: Europa Idioma: En Revista: Diabetes Obes Metab Asunto de la revista: ENDOCRINOLOGIA / METABOLISMO Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido