Association among diabetes, cardiovascular disease and mortality in patients hospitalised for COVID-19: an analysis of the American Heart Association COVID-19 CVD Registry
Objective To examine inpatient COVID-19-related outcomes among patients with and without diabetes alone or with a history of established heart failure (HF) or established atherosclerotic cardiovascular disease (ASCVD).Design Observational study; longitudinal analysis of registry data.Setting Hospita...
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BMJ Publishing Group
2024-12-01
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| author | Arshed Quyyumi Abhinav Goyal Sandeep Das Unjali Gujral Lauren T Vanasse Colby Ayers Francisco Pasquel |
| author_facet | Arshed Quyyumi Abhinav Goyal Sandeep Das Unjali Gujral Lauren T Vanasse Colby Ayers Francisco Pasquel |
| author_sort | Arshed Quyyumi |
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| description | Objective To examine inpatient COVID-19-related outcomes among patients with and without diabetes alone or with a history of established heart failure (HF) or established atherosclerotic cardiovascular disease (ASCVD).Design Observational study; longitudinal analysis of registry data.Setting Hospitals in the USA reporting to the American Heart Association (AHA) COVID-19 Registry from January 2020 to May 2021.Participants 20 796 individuals with diabetes (11 244 men; mean age 64.2) and 30 798 without diabetes (15 980 men; mean age 59.0) hospitalised for COVID-19 in the USA.Primary and secondary outcome measures Primary outcome measures were all-cause mortality, inpatient major adverse cardiovascular events (MACE) and/or inpatient mechanical ventilation. Secondary outcome measures included the association with diabetes and these outcomes among those with and without pre-existing ASCVD and HF and the association with insulin use and these outcomes in patients hospitalised for COVID-19.Results After adjustment for relevant covariates diabetes increased the risk of mortality (HR 1.12, 95% CI: 1.03 to 1.21), MACE (HR 1.32, 95% CI: 1.17 to 1.48) and mechanical ventilation (HR 1.33, 95% CI: 1.26 to 1.42). Among patients with established ASCVD or HF, diabetes did not modify the risk of adverse outcomes. There was a significant difference in the risk of mortality between patients taking insulin compared with those who were not (HR 1.32, 95% CI: 1.01 to 1.26); however, there was no difference in the risk of MACE or mechanical ventilation.Conclusions Diabetes was associated with a higher risk of in-hospital all-cause mortality, MACE and need for mechanical ventilation in patients hospitalised for COVID-19. Diabetes was independently associated with adverse outcomes, particularly among those without pre-existing cardiovascular disease. |
| format | Article |
| id | doaj-art-3f9d7afacf714177ac3dcf33e6642a8d |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-3f9d7afacf714177ac3dcf33e6642a8d2025-08-20T02:36:31ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2024-084087Association among diabetes, cardiovascular disease and mortality in patients hospitalised for COVID-19: an analysis of the American Heart Association COVID-19 CVD RegistryArshed Quyyumi0Abhinav Goyal1Sandeep Das2Unjali Gujral3Lauren T Vanasse4Colby Ayers5Francisco Pasquel64 Division of Cardiology, Emory University, Atlanta, Georgia, USA3 School of Medicine, Emory University, Atlanta, Georgia, USA6 Medicine/Cardiology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA1 Rollins School of Public Health, Emory University, Atlanta, Georgia, USA2 Emory University, Atlanta, Georgia, USA5 UT Southwestern Medical Center, Dallas, Texas, USA7 Medicine/Endocrinology, Emory University School of Medicine, Atlanta, Georgia, USAObjective To examine inpatient COVID-19-related outcomes among patients with and without diabetes alone or with a history of established heart failure (HF) or established atherosclerotic cardiovascular disease (ASCVD).Design Observational study; longitudinal analysis of registry data.Setting Hospitals in the USA reporting to the American Heart Association (AHA) COVID-19 Registry from January 2020 to May 2021.Participants 20 796 individuals with diabetes (11 244 men; mean age 64.2) and 30 798 without diabetes (15 980 men; mean age 59.0) hospitalised for COVID-19 in the USA.Primary and secondary outcome measures Primary outcome measures were all-cause mortality, inpatient major adverse cardiovascular events (MACE) and/or inpatient mechanical ventilation. Secondary outcome measures included the association with diabetes and these outcomes among those with and without pre-existing ASCVD and HF and the association with insulin use and these outcomes in patients hospitalised for COVID-19.Results After adjustment for relevant covariates diabetes increased the risk of mortality (HR 1.12, 95% CI: 1.03 to 1.21), MACE (HR 1.32, 95% CI: 1.17 to 1.48) and mechanical ventilation (HR 1.33, 95% CI: 1.26 to 1.42). Among patients with established ASCVD or HF, diabetes did not modify the risk of adverse outcomes. There was a significant difference in the risk of mortality between patients taking insulin compared with those who were not (HR 1.32, 95% CI: 1.01 to 1.26); however, there was no difference in the risk of MACE or mechanical ventilation.Conclusions Diabetes was associated with a higher risk of in-hospital all-cause mortality, MACE and need for mechanical ventilation in patients hospitalised for COVID-19. Diabetes was independently associated with adverse outcomes, particularly among those without pre-existing cardiovascular disease.https://bmjopen.bmj.com/content/14/12/e084087.full |
| spellingShingle | Arshed Quyyumi Abhinav Goyal Sandeep Das Unjali Gujral Lauren T Vanasse Colby Ayers Francisco Pasquel Association among diabetes, cardiovascular disease and mortality in patients hospitalised for COVID-19: an analysis of the American Heart Association COVID-19 CVD Registry BMJ Open |
| title | Association among diabetes, cardiovascular disease and mortality in patients hospitalised for COVID-19: an analysis of the American Heart Association COVID-19 CVD Registry |
| title_full | Association among diabetes, cardiovascular disease and mortality in patients hospitalised for COVID-19: an analysis of the American Heart Association COVID-19 CVD Registry |
| title_fullStr | Association among diabetes, cardiovascular disease and mortality in patients hospitalised for COVID-19: an analysis of the American Heart Association COVID-19 CVD Registry |
| title_full_unstemmed | Association among diabetes, cardiovascular disease and mortality in patients hospitalised for COVID-19: an analysis of the American Heart Association COVID-19 CVD Registry |
| title_short | Association among diabetes, cardiovascular disease and mortality in patients hospitalised for COVID-19: an analysis of the American Heart Association COVID-19 CVD Registry |
| title_sort | association among diabetes cardiovascular disease and mortality in patients hospitalised for covid 19 an analysis of the american heart association covid 19 cvd registry |
| url | https://bmjopen.bmj.com/content/14/12/e084087.full |
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