Article ; Online: Association of renin-angiotensin-aldosterone system inhibitors with best COVID-19 outcomes in a diabetic population of the Veneto region (north-east Italy): A lesson for endemic phase?
2023
Abstract: Diabetes mellitus is a prevalent chronic disease in patients who die of COVID-19. The aim of this study was to investigate the clinical and metabolic characteristics of diabetic patients with COVID-19 during the pre-vaccination phase. A retrospective ... ...
| Abstract | Diabetes mellitus is a prevalent chronic disease in patients who die of COVID-19. The aim of this study was to investigate the clinical and metabolic characteristics of diabetic patients with COVID-19 during the pre-vaccination phase. A retrospective cohort study was conducted from February 2020 to February 2021 to examine the clinical and metabolic profiles of unvaccinated diabetic patients affected by COVID-19. Data were collected from claim databases, hospital discharge records, and clinical records within a healthcare district located in northeastern Italy with a population of 936,000. Potential prognostic indicators including sex, age, Body Mass Index (BMI), duration and type of diabetes, metabolic control, and the use of antidiabetic, antihypertensive, lipid-lowering, and antiplatelet therapies were investigated. For hospitalized patients, additional variables were recorded, such as length of hospital stay, blood pressure at admission, comorbidities, D-dimer levels, blood glucose (BG), in-hospital insulin and corticosteroid therapies, requirement for mechanical ventilation (i.e., orotracheal or tracheostomy), admission to the Intensive Care Unit (ICU), and mortality. Diabetic patients hospitalized for COVID-19 with a poorer prognosis were characterized by advanced age, longer diabetes duration, hypertension, higher usage of sulfonylureas, and lower usage of dietotherapy alone, metformin, Glucagon-Like Peptide-1 Receptor agonists (GLP1-Ra), and Renin-Angiotensin-Aldosterone System inhibitors (RAAS-i). Considering the potential for COVID-19 to become endemic, special care should be taken in managing older diabetic patients’ treatments. |
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| Keywords | COVID-19 infection ; adrenal cortex hormones ; blood glucose ; blood pressure ; body mass index ; chronic diseases ; cohort studies ; diabetes mellitus ; elderly ; glucagon-like peptide 1 ; health services ; hospitals ; hypertension ; insulin ; metabolism ; metformin ; mortality ; nutrition ; prognosis ; sulfonylureas ; Italy ; Diabetes ; COVID-19 ; Metabolic control ; RAAS-i ; ACE2 ; ACEi ; AH1N1 ; ARBs ; BG ; BMI ; CI ; DPP-4 ; DPP-4i ; GLP1-Ra ; HDR ; HR ; ICD9-CM ; ICU ; INIH ; MERS-CoV ; SARS ; SD ; SGLT2-i |
| Language | English |
| Dates of publication | 2023-0624 |
| Publishing place | Elsevier B.V. |
| Document type | Article ; Online |
| Note | Pre-press version |
| ZDB-ID | 1067704-5 |
| ISSN | 0939-4753 |
| ISSN | 0939-4753 |
| DOI | 10.1016/j.numecd.2023.06.016 |
| Database | NAL-Catalogue (AGRICOLA) |
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