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Diabetes mellitus, glycaemic control, and severe COVID-19 in the Australian critical care setting: A nested cohort study

2022; Elsevier BV; Volume: 36; Issue: 4 Linguagem: Inglês

10.1016/j.aucc.2022.05.002

1878-1721

Mark P. Plummer, Louise Rait, Mark Finnis, Craig French, Samantha Bates, James S. Douglas, Mansi Bhurani, Tessa Broadley, Tony Trapani, Adam M. Deane, Andrew Udy, Aidan Burrell, Adam Visser, Adrian Mattke, Adrian Regli, Alan Rashid, Alexis Tabah, Alison Walker, Allen C. Cheng, Amanda Corley, Andrew Udy, Anil Ramnani, Anthony Eidan, Bart DeKeulenaer, Benjamin Reddi, Brent Richards, Cameron Knott, Cara Moore, Carmel Delzoppo, Catherine Boschert, Catherine Tacon, Craig French, Danielle Austin, David Brewster, D. James Cooper, David Crosbie, David Hawkins, Edda Jessen, Eduardo Martínez, Edward Fysh, Edward Litton, Felix Oberender, Forbes McGain, Gavin Salt, Glenn M. Eastwood, Gopal Taori, Hayden White, Hergen Buscher, Ian Seppelt, I. Anne Leditschke, Janelle Young, Jayshree Lavana, Jérémy Cohen, Jessica Lugsdin, John Botha, John Santamaria, Jonathan Barrett, Kasha P. Singh, Kevin B. Laupland, Khaled El-Khawas, Kristine Estensen, Kush Deshpande, Kyle White, Leigh Fitzpatrick, Lewis Campbell, Mahesh Ramanan, Manoj Saxena, Marion Kainer, Mark Kol, Mark Page, Mark P. Plummer, Martin Štěrba, Matthew Anstey, Matthew J. Brain, Matthew J. Maiden, Myrene Kilminster, Naomi Hammond, Neeraj Bhadange, Nicole Humphreys, Paras Jain, P. Azzi, Paul Secombe, Paula Lister, Peter Chan, Peter McCanny, Philip N Britton, Pierre Janin, Ravi Krishnamurthy, Ravikiran Sonawane, Ravindranath Tiruvoipati, Richard Totaro, Rinaldo Bellomo, Ritesh Sanghavi, Samantha Bates, Sandra Peake, Shailesh Bihari, Shane George, Simon Erickson, Steve Webb, Subhash Arora, Subodh Ganu, Thomas Rozen, Toni McKenna, Umesh Kadam, Vineet Nayyar, Wei Han Choy, Wisam Al‐Bassam,

Diabetes and associated disorders

BackgroundInternationally, diabetes mellitus is recognised as a risk factor for severe COVID-19. The relationship between diabetes mellitus and severe COVID-19 has not been reported in the Australian population.ObjectiveThe objective of this study was to determine the prevalence of and outcomes for patients with diabetes admitted to Australian intensive care units (ICUs) with COVID-19.MethodsThis is a nested cohort study of four ICUs in Melbourne participating in the Short Period Incidence Study of Severe Acute Respiratory Infection (SPRINT-SARI) Australia project. All adult patients admitted to the ICU with COVID-19 from 20 February 2020 to 27 February 2021 were included. Blood glucose and glycated haemoglobin (HbA1c) data were retrospectively collected. Diabetes was diagnosed from medical history or an HbA1c ≥6.5% (48 mmol/mol). Hospital mortality was assessed using logistic regression.ResultsThere were 136 patients with median age 58 years [48–68] and median Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 14 [11–19]. Fifty-eight patients had diabetes (43%), 46 patients had stress-induced hyperglycaemia (34%), and 32 patients had normoglycaemia (23%). Patients with diabetes were older, were with higher APACHE II scores, had greater glycaemic variability than patients with normoglycaemia, and had longer hospital length of stay. Overall hospital mortality was 16% (22/136), including nine patients with diabetes, nine patients with stress-induced hyperglycaemia, and two patients with normoglycaemia.ConclusionDiabetes is prevalent in patients admitted to Australian ICUs with severe COVID-19, highlighting the need for prevention strategies in this vulnerable population.