Effects of Diabetes and Blood Glucose on COVID-19 Mortality: A Retrospective Observational Study

OBJECTIVETo investigate the association of diabetes and blood glucose on mortality of patients with Coronavirus Disease 2019 (COVID-19).RESEARCH DESIGN AND METHODSThis was a retrospective observational study of all patients with COVID-19 admitted to Huo-Shen-Shan Hospital, Wuhan, China. The hospital was built only for treating COVID-19 and opened on February 5, 2020. The primary endpoint was all-cause mortality during hospitalization.RESULTSAmong 2877 hospitalized patients, 13.5% (387/2877) had a history of diabetes and 1.9% (56/2877) died in hospital. After adjustment for confounders, patients with diabetes had a 2-fold increase in the hazard of mortality as compared to patients without diabetes (adjusted HR 2.11, 95%CI: 1.16-3.83, P=0.014). The on-admission glucose (per mmol/L≥4mmol/L) was significantly associated with subsequent mortality on COVID-19 (adjusted HR 1.17, 95%CI: 1.10-1.24, P<0.001).CONCLUSIONSDiabetes and on-admission glucose (per mmol/L≥4mmol/L) are associated with increased mortality in patients with COVID-19. These data support that blood glucose should be properly controlled for possibly better survival outcome in patients with COVID-19.

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Association of hypertension and antihypertensive treatment with COVID-19 mortality: a retrospective observational study

European Heart Journal ◽

10.1093/eurheartj/ehaa433 ◽

2020 ◽

Vol 41 (22) ◽

pp. 2058-2066 ◽

Cited By ~ 76

Author(s):

Chao Gao ◽

Yue Cai ◽

Kan Zhang ◽

Lei Zhou ◽

Yao Zhang ◽

...

Keyword(s):

Relative Risk ◽

Observational Study ◽

Antihypertensive Treatment ◽

Meta Analysis ◽

Fold Increase ◽

Retrospective Observational Study ◽

Risk Of Mortality ◽

Increased Risk ◽

History Of ◽

Antihypertensive Treatments

Abstract Aims It remains unknown whether the treatment of hypertension influences the mortality of patients diagnosed with coronavirus disease 2019 (COVID-19). Methods and results This is a retrospective observational study of all patients admitted with COVID-19 to Huo Shen Shan Hospital. The hospital was dedicated solely to the treatment of COVID-19 in Wuhan, China. Hypertension and the treatments were stratified according to the medical history or medications administrated prior to the infection. Among 2877 hospitalized patients, 29.5% (850/2877) had a history of hypertension. After adjustment for confounders, patients with hypertension had a two-fold increase in the relative risk of mortality as compared with patients without hypertension [4.0% vs. 1.1%, adjusted hazard ratio (HR) 2.12, 95% confidence interval (CI) 1.17–3.82, P = 0.013]. Patients with a history of hypertension but without antihypertensive treatment (n = 140) were associated with a significantly higher risk of mortality compared with those with antihypertensive treatments (n = 730) (7.9% vs. 3.2%, adjusted HR 2.17, 95% CI 1.03–4.57, P = 0.041). The mortality rates were similar between the renin–angiotensin–aldosterone system (RAAS) inhibitor (4/183) and non-RAAS inhibitor (19/527) cohorts (2.2% vs. 3.6%, adjusted HR 0.85, 95% CI 0.28–2.58, P = 0.774). However, in a study-level meta-analysis of four studies, the result showed that patients with RAAS inhibitor use tend to have a lower risk of mortality (relative risk 0.65, 95% CI 0.45–0.94, P = 0.20). Conclusion While hypertension and the discontinuation of antihypertensive treatment are suspected to be related to increased risk of mortality, in this retrospective observational analysis, we did not detect any harm of RAAS inhibitors in patients infected with COVID-19. However, the results should be considered as exploratory and interpreted cautiously.

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Which variables are associated with blood glucose levels outside the target range in surgical critically ill patients? A retrospective observational study

Patient Safety in Surgery ◽

10.1186/1754-9493-5-5 ◽

2011 ◽

Vol 5 (1) ◽

pp. 5 ◽

Cited By ~ 3

Author(s):

Manfred Weiss ◽

Martina Kron ◽

Birgit Hay ◽

Michael Taenzer ◽

Peter Radermacher ◽

...

Keyword(s):

Blood Glucose ◽

Observational Study ◽

Critically Ill ◽

Critically Ill Patients ◽

Retrospective Observational Study ◽

Target Range ◽

Glucose Levels ◽

Blood Glucose Levels

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Red Cell Distribution Width Is Associated with All-Cause and Cardiovascular Mortality in Patients with Diabetes

BioMed Research International ◽

10.1155/2017/5843702 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 8

Author(s):

Sadeer G. Al-Kindi ◽

Marwan Refaat ◽

Amin Jayyousi ◽

Nidal Asaad ◽

Jassim Al Suwaidi ◽

...

Keyword(s):

Cardiovascular Mortality ◽

Red Cell Distribution Width ◽

Red Cell ◽

Cell Distribution ◽

Distribution Width ◽

Health And Nutrition ◽

Increased Risk ◽

All Cause Mortality ◽

Patients With Diabetes ◽

History Of

Background and Methods. Red cell distribution width (RDW) has emerged as a prognostic marker in patients with cardiovascular diseases. We investigated mortality in patients with diabetes included in the National Health and Nutrition Examination Survey, in relation to baseline RDW. RDW was divided into 4 quartiles (Q1: ≤12.4%, Q2: 12.5%–12.9%, Q3: 13.0%–13.7%, and Q4: >13.7%). Results. A total of 3,061 patients were included: mean age 61±14 years, 50% male, 39% White. Mean RDW was 13.2%±1.4%. Compared with first quartile (Q1) of RDW, patients in Q4 were more likely to be older, female, and African-American, have had history of stroke, myocardial infarction, and heart failure, and have chronic kidney disease. After a median follow-up of 6 years, 628 patient died (29% of cardiovascular disease). Compared with Q1, patients in Q4 were at increased risk for all-cause mortality (HR 3.44 [2.74–4.32], P<.001) and cardiovascular mortality (HR 3.34 [2.16–5.17], P<.001). After adjusting for 17 covariates, RDW in Q4 remained significantly associated with all-cause mortality (HR 2.39 [1.30–4.38], P=0.005) and cardiovascular mortality (HR 1.99 [1.17–3.37], P=0.011). Conclusion. RDW is a powerful and an independent marker for prediction of all-cause mortality and cardiovascular mortality in patients with diabetes.

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Outcomes of pregnancy in Egyptian women with multiple sclerosis in the new treatment era: a multi-center retrospective observational study

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-021-00386-1 ◽

2021 ◽

Vol 57 (1) ◽

Author(s):

Ali Mahmoud Ahmed ◽

Mohamed Al-Bahay M. G. Reda ◽

Ahmed Hassan Elsheshiny

Keyword(s):

Multiple Sclerosis ◽

Observational Study ◽

Exclusive Breastfeeding ◽

Retrospective Observational Study ◽

Third Trimester ◽

Early Postpartum ◽

Egyptian Women ◽

History Of ◽

New Treatment ◽

The Relationship

Abstract Background Pregnancy is a recent growing issue in multiple sclerosis (MS) and the update in the diagnostic criteria of MS and introduction of many disease-modifying therapies (DMTs) may cause changes in the relationship between MS, pregnancy, and breastfeeding. This study aimed to investigate the effect of pregnancy and breastfeeding on MS and vice versa. A retrospective observational study was conducted to include MS women with a history of at least one pregnancy during the last 7 years. Data were collected from the archived files in addition to a self-administrating questionnaire. The annualized relapsing rate (ARR) was calculated before, during, and after pregnancy. Results We included 116 successful pregnancies from 93 MS women with mean age 32.74 ± 5.12 years. Interferon-beta was the commonly used DMT during and after pregnancy. Despite the ARR during the two years preceding the conception was 0.36 (95% CI 0.32–0.41), this rate was significantly decreased during first, second, and third trimester (0.07; 95% CI 0.04–0.15, 0.10; 95% CI 0.03–0.17, and 0.15; 95% CI 0.08–0.24, respectively; P-value < 0.001 in all). Furthermore, this ARR was significantly decreased during the first and last three months after delivery (0.27; 95% CI 0.16–0.39; P-value = 0.037, and 0.24; 95% CI 0.17–0.38; P-value = 0.023). Exclusive breastfeeding was associated with deceased risk of postpartum relapse, with HR 0.31 (95% CI 0.12–0.67; P = 0.002). Conclusions Pregnancy is protective from MS relapse, with a significant decrease of ARR from the pre-pregnancy period. Postpartum reactivation of the disease occurs from the third month after labor, rather than the early postpartum period. Exclusive breastfeeding for at least 2 months decreased the risk of postpartum relapse.

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The Occurrence of Seizure Clusters in Patients With Epilepsy Is Partly Determined by Epilepsy Severity: A Single-Center Retrospective Observational Study

Frontiers in Neurology ◽

10.3389/fneur.2021.794086 ◽

2021 ◽

Vol 12 ◽

Author(s):

Rui Zhong ◽

Qingling Chen ◽

Xinyue Zhang ◽

Weihong Lin

Keyword(s):

Logistic Regression ◽

Observational Study ◽

Regression Models ◽

Final Analysis ◽

Retrospective Observational Study ◽

Logistic Regression Models ◽

History Of ◽

Drug Resistant Epilepsy ◽

The Individual ◽

Patients With Epilepsy

Purpose: This retrospective observational study aimed to investigate the self-reported prevalence of seizure clusters (SCs) in patients with epilepsy (PWE) and its relationship with clinical characteristics.Methods: We retrospectively analyzed data from consecutive PWE from our hospital in northeastern China. Data were collected from the databank of a tertiary epilepsy center. Logistic regression models were employed to investigate the relationships between the individual patient demographic/clinical variables and the occurrence of SC.Results: In total, 606 consecutive PWE were included in the final analysis, and 268 (44.2%) patients experienced at least one seizure cluster. In multivariate logistic regression models, age (OR: 1.014; 95% CI: 1.002–1.027; p = 0.02), seizure frequency (OR: 2.08; 95% CI: 1.555–2.783; p < 0.001), multiple seizure types (OR: 5.111; 95% CI: 1.737–15.043; p = 0.003), number of current anti-seizure medications (ASM) (OR: 1.533; 95% CI: 1.15–2.042; p = 0.004), drug-resistant epilepsy (OR: 1.987; 95% CI: 1.159–3.407; p = 0.013), and a history of status epilepticus (OR: 1.903; 95% CI: 1.24–2.922; p = 0.003) were independent variables associated with a history of SC in PWE.Conclusion: Seizure clusters (SCs) are common occurrences at our study center. The occurrence of SC in individuals with epilepsy, to some extent, is determined by the epilepsy severity.

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Understanding the use of email consultation in primary care using a retrospective observational study with data of Dutch electronic health records

BMJ Open ◽

10.1136/bmjopen-2017-019233 ◽

2018 ◽

Vol 8 (1) ◽

pp. e019233 ◽

Cited By ~ 8

Author(s):

Martine W J Huygens ◽

Ilse C S Swinkels ◽

Robert A Verheij ◽

Roland D Friele ◽

Onno C P van Schayck ◽

...

Keyword(s):

Primary Care ◽

General Practice ◽

Observational Study ◽

Patient Characteristics ◽

Retrospective Observational Study ◽

Electronic Health Record Data ◽

Face To Face ◽

Patients With Diabetes ◽

General Practices ◽

Electronic Health

ObjectivesIt is unclear why the use of email consultation is not more widespread in Dutch general practice, particularly because, since 2006, its costs can be reimbursed. To encourage further implementation, it is needed to understand the current use of email consultations. This study aims to understand the use of email consultation by different patient groups, compared with other general practice (GP) consultations.SettingFor this retrospective observational study, we used Dutch routine electronic health record data obtained from NIVEL Primary Care Database for the years 2010 and 2014.Participants200 general practices were included in 2010 (734 122 registered patients) and 434 in 2014 (1 630 386 registered patients).Primary outcome measuresThe number and percentage of email consultations and patient characteristics (age, gender, neighbourhood socioeconomic status and diagnoses) of email consultation users were investigated and compared with those who had a telephone or face-to-face consultation. General practice characteristics were also taken into account.Results32.0% of the Dutch general practices had at least one email consultation in 2010, rising to 52.8% in 2014. In 2014, only 0.7% of the GP consultations were by email (the others comprised home visits, telephone and face-to-face consultations). Its use highly varied among general practices. Most email consultations were done for psychological (14.7%); endocrine, metabolic and nutritional (10.9%); and circulatory (10.7%) problems. These diagnosis categories appeared less frequently in telephone and face-to-face consultations. Patients who had an email consultation were older than patients who had a telephone or face-to-face consultation. In contrast, patients with diabetes who had an email consultation were younger.ConclusionEven though email consultation was done in half the general practices in the Netherlands in 2014, the actual use of it is extremely low. Patients who had an email consultation differ from those who had a telephone or face-to-face consultation. In addition, the use of email consultation by patients is dependent on its provision by GPs.

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All-cause mortality risk in elderly individuals with disabilities: a retrospective observational study

BMJ Open ◽

10.1136/bmjopen-2016-011164 ◽

2016 ◽

Vol 6 (9) ◽

pp. e011164 ◽

Cited By ~ 21

Author(s):

Li-Wei Wu ◽

Wei-Liang Chen ◽

Tao-Chun Peng ◽

Sheng-Ta Chiang ◽

Hui-Fang Yang ◽

...

Keyword(s):

Observational Study ◽

Mortality Risk ◽

Retrospective Observational Study ◽

Individuals With Disabilities ◽

Elderly Individuals ◽

All Cause Mortality

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Time in blood glucose range 70 to 180 mg/dL and survival rate in critically ill patients: A retrospective observational study

10.1101/2020.08.31.20184994 ◽

2020 ◽

Author(s):

Hiromu Naraba ◽

Tadahiro Goto ◽

Toru Shirakawa ◽

Tomohiro Sonoo ◽

Naoki Kanda ◽

...

Keyword(s):

Blood Glucose ◽

Observational Study ◽

Critically Ill ◽

Critically Ill Patients ◽

Tertiary Care ◽

Cox Proportional Hazards Model ◽

Retrospective Observational Study ◽

Sensitivity Analyses ◽

Increased Risk ◽

Blood Glucose Range

Objective: Time in targeted blood glucose range (TIR) 70-140 mg/dL has been associated with an increased risk of mortality in critically ill patients. Nevertheless, it remains unclear whether TIR is associated with 28-day mortality in critically ill patients under glycemic control with a less tight target glucose range of 70-180 mg/dL. We aimed to assess whether TIR 70-180 mg/dL was associated with 28-day mortality and to identify the optimal TIR. Design: A retrospective observational study. Setting: Data from a tertiary care centre in Japan, from 1 January 2016 through 31 October 2019. Participants: 1,230 adult patients admitted to the intensive care unit for more than three days. Outcome measure: The primary outcome was 28-day mortality. Results: Of 1,230 patients, patients with HbA1c ≥6.5% had a higher 28-day mortality than those with <6.5% (32.0% vs. 22.7%; p=0.003). In the multivariate logistic regression, TIR <80% was associated with an increased risk of 28-day mortality in patients with HbA1c <6.5% with an adjusted odds ratio (OR) of 1.88 (95% confidence interval [CI]: 1.36-2.61). When using 10% incremental TIR as a categorical variable, lower TIR was associated with worse 28-day mortality compared to TIR ≥90% in patients with HbA1c <6.5% (e.g., adjusted OR of TIR <60%, 3.62 [95%CI 2.36-5.53]). Similar associations were found in the analyses using the COX proportional hazards model. In addition, sensitivity analyses using TIR of the first three days showed that the overall associations were consistent with primary analyses. Conclusions: Our study demonstrated that lower TIR 70-180 mg/dL was associated with higher 28-day mortality in nondiabetic critically ill patients.

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