Diabetes associates with mortality in critically ill patients with SARS-CoV-2 pneumonia : no diabetes paradox in COVID-19
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/270814 |
Resumo: | Background: Diabetes mellitus (DM) is not associated with increased mortality in critically ill patients, a phenomenon known as the “diabetes paradox”. However, DM is a risk factor for increased mortality in patients with COVID-19. This study aims to investigate the association of DM and stress-induced hyperglycemia at intensive care unit (ICU) with mortality in this population. Methods: This is a retrospective study. Electronic medical records from patients admitted from March 2020 to September 2020 were reviewed. Primary outcome was mortality. Secondary outcomes were ICU and hospital mortality and stay, and need for mechanical ventilation and renal replacement therapy. Results: 187 patients were included. Overall mortality was 43.2%, higher in patients with DM (55.7% vs. 34%; p = 0.007), even after adjustment for age, hypertension, and disease severity. When patients were separated into groups, named normoglycemia (without DM and glycemia ≤140 mg/dL), stress-induced hyperglycemia (without DM and glycemia >140 mg/dL), and DM (previous diagnosis or HbA1c ≥ 6.5%), the mortality rate was 25.8%, 37.3%, and 55.7%, respectively (p = 0.021). Mortality was higher in patients with higher glycemic variability. No statistical difference related to secondary outcomes was observed. Conclusions: DM, hyperglycemia, and glycemic variability associated with increased mortality in critically ill patients with severe COVID-19, but did not increase the rates of other clinical outcomes. More than stress-induced hyperglycemia, DM was associated with mortality. |
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Bellaver, PriscilaSchneider, LarissaSchaeffer, Ariell FreiresHenrique, Lilian RodriguesCamargo, Joiza LinsGerchman, FernandoLeitão, Cristiane BauermannRech, Tatiana Helena2024-01-11T03:24:51Z20232405-8440http://hdl.handle.net/10183/270814001193223Background: Diabetes mellitus (DM) is not associated with increased mortality in critically ill patients, a phenomenon known as the “diabetes paradox”. However, DM is a risk factor for increased mortality in patients with COVID-19. This study aims to investigate the association of DM and stress-induced hyperglycemia at intensive care unit (ICU) with mortality in this population. Methods: This is a retrospective study. Electronic medical records from patients admitted from March 2020 to September 2020 were reviewed. Primary outcome was mortality. Secondary outcomes were ICU and hospital mortality and stay, and need for mechanical ventilation and renal replacement therapy. Results: 187 patients were included. Overall mortality was 43.2%, higher in patients with DM (55.7% vs. 34%; p = 0.007), even after adjustment for age, hypertension, and disease severity. When patients were separated into groups, named normoglycemia (without DM and glycemia ≤140 mg/dL), stress-induced hyperglycemia (without DM and glycemia >140 mg/dL), and DM (previous diagnosis or HbA1c ≥ 6.5%), the mortality rate was 25.8%, 37.3%, and 55.7%, respectively (p = 0.021). Mortality was higher in patients with higher glycemic variability. No statistical difference related to secondary outcomes was observed. Conclusions: DM, hyperglycemia, and glycemic variability associated with increased mortality in critically ill patients with severe COVID-19, but did not increase the rates of other clinical outcomes. More than stress-induced hyperglycemia, DM was associated with mortality.application/pdfengHeliyon. London. Vol. 9 (2023), e18554, 9 p.Cuidados críticosDiabetes mellitusUnidades de terapia intensivaHiperglicemiaCOVID-19MortalidadeSARS-CoV-2PneumoniaSARS-CoV-2 infectionHyperglycemiaDiabetic paradoxCritical illnessDiabetes associates with mortality in critically ill patients with SARS-CoV-2 pneumonia : no diabetes paradox in COVID-19Estrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001193223.pdf.txt001193223.pdf.txtExtracted Texttext/plain40905http://www.lume.ufrgs.br/bitstream/10183/270814/2/001193223.pdf.txt35ad48bf83868a89c1c56ed2dd830454MD52ORIGINAL001193223.pdfTexto completo (inglês)application/pdf1772784http://www.lume.ufrgs.br/bitstream/10183/270814/1/001193223.pdf58c4596642844124cb97cdd4f0b2fae1MD5110183/2708142024-01-12 04:27:54.641089oai:www.lume.ufrgs.br:10183/270814Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2024-01-12T06:27:54Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Diabetes associates with mortality in critically ill patients with SARS-CoV-2 pneumonia : no diabetes paradox in COVID-19 |
title |
Diabetes associates with mortality in critically ill patients with SARS-CoV-2 pneumonia : no diabetes paradox in COVID-19 |
spellingShingle |
Diabetes associates with mortality in critically ill patients with SARS-CoV-2 pneumonia : no diabetes paradox in COVID-19 Bellaver, Priscila Cuidados críticos Diabetes mellitus Unidades de terapia intensiva Hiperglicemia COVID-19 Mortalidade SARS-CoV-2 Pneumonia SARS-CoV-2 infection Hyperglycemia Diabetic paradox Critical illness |
title_short |
Diabetes associates with mortality in critically ill patients with SARS-CoV-2 pneumonia : no diabetes paradox in COVID-19 |
title_full |
Diabetes associates with mortality in critically ill patients with SARS-CoV-2 pneumonia : no diabetes paradox in COVID-19 |
title_fullStr |
Diabetes associates with mortality in critically ill patients with SARS-CoV-2 pneumonia : no diabetes paradox in COVID-19 |
title_full_unstemmed |
Diabetes associates with mortality in critically ill patients with SARS-CoV-2 pneumonia : no diabetes paradox in COVID-19 |
title_sort |
Diabetes associates with mortality in critically ill patients with SARS-CoV-2 pneumonia : no diabetes paradox in COVID-19 |
author |
Bellaver, Priscila |
author_facet |
Bellaver, Priscila Schneider, Larissa Schaeffer, Ariell Freires Henrique, Lilian Rodrigues Camargo, Joiza Lins Gerchman, Fernando Leitão, Cristiane Bauermann Rech, Tatiana Helena |
author_role |
author |
author2 |
Schneider, Larissa Schaeffer, Ariell Freires Henrique, Lilian Rodrigues Camargo, Joiza Lins Gerchman, Fernando Leitão, Cristiane Bauermann Rech, Tatiana Helena |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Bellaver, Priscila Schneider, Larissa Schaeffer, Ariell Freires Henrique, Lilian Rodrigues Camargo, Joiza Lins Gerchman, Fernando Leitão, Cristiane Bauermann Rech, Tatiana Helena |
dc.subject.por.fl_str_mv |
Cuidados críticos Diabetes mellitus Unidades de terapia intensiva Hiperglicemia COVID-19 Mortalidade SARS-CoV-2 Pneumonia |
topic |
Cuidados críticos Diabetes mellitus Unidades de terapia intensiva Hiperglicemia COVID-19 Mortalidade SARS-CoV-2 Pneumonia SARS-CoV-2 infection Hyperglycemia Diabetic paradox Critical illness |
dc.subject.eng.fl_str_mv |
SARS-CoV-2 infection Hyperglycemia Diabetic paradox Critical illness |
description |
Background: Diabetes mellitus (DM) is not associated with increased mortality in critically ill patients, a phenomenon known as the “diabetes paradox”. However, DM is a risk factor for increased mortality in patients with COVID-19. This study aims to investigate the association of DM and stress-induced hyperglycemia at intensive care unit (ICU) with mortality in this population. Methods: This is a retrospective study. Electronic medical records from patients admitted from March 2020 to September 2020 were reviewed. Primary outcome was mortality. Secondary outcomes were ICU and hospital mortality and stay, and need for mechanical ventilation and renal replacement therapy. Results: 187 patients were included. Overall mortality was 43.2%, higher in patients with DM (55.7% vs. 34%; p = 0.007), even after adjustment for age, hypertension, and disease severity. When patients were separated into groups, named normoglycemia (without DM and glycemia ≤140 mg/dL), stress-induced hyperglycemia (without DM and glycemia >140 mg/dL), and DM (previous diagnosis or HbA1c ≥ 6.5%), the mortality rate was 25.8%, 37.3%, and 55.7%, respectively (p = 0.021). Mortality was higher in patients with higher glycemic variability. No statistical difference related to secondary outcomes was observed. Conclusions: DM, hyperglycemia, and glycemic variability associated with increased mortality in critically ill patients with severe COVID-19, but did not increase the rates of other clinical outcomes. More than stress-induced hyperglycemia, DM was associated with mortality. |
publishDate |
2023 |
dc.date.issued.fl_str_mv |
2023 |
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2024-01-11T03:24:51Z |
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Estrangeiro info:eu-repo/semantics/article |
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http://hdl.handle.net/10183/270814 |
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2405-8440 |
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001193223 |
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2405-8440 001193223 |
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http://hdl.handle.net/10183/270814 |
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Heliyon. London. Vol. 9 (2023), e18554, 9 p. |
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openAccess |
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