Biomarkers Predictive for In-Hospital Mortality in Patients with Diabetes Mellitus and Prediabetes Hospitalized for COVID-19 in Austria: An Analysis of COVID-19 in Diabetes Registry.

Interdisciplinary Metabolic Medicine Trials Unit, Department of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria.Interdisciplinary Metabolic Medicine Trials Unit, Department of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria.Medical Division for Endocrinology, Rheumatology and Acute Geriatrics, Wilhelminen Hospital Vienna, 1160 Vienna, Austria.Clinical Division for Internal Medicine, Endocrinology, Diabetology and Metabolic Diseases, St. Vinzenz Hospital Zams, 6511 Zams, Austria.Clinical Division for Internal Medicine, Konventhospital Barmherzige Brüder Linz, 4020 Linz, Austria.Medical Division for Endocrinology, Rheumatology and Acute Geriatrics, Wilhelminen Hospital Vienna, 1160 Vienna, Austria.4th Medical Division with Infectiology, SMZ Süd-KFJ-Hospital Vienna, 1100 Vienna, Austria.Clinical Division for Endocrinology and Diabetology and Metabolic Diseases, AKH Vienna, 1090 Vienna, Austria.Clinical Division for Internal Medicine, Konventhospital Barmherzige Brüder Linz, 4020 Linz, Austria.Interdisciplinary Metabolic Medicine Trials Unit, Department of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria.Interdisciplinary Metabolic Medicine Trials Unit, Department of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria.4th Medical Division with Infectiology, SMZ Süd-KFJ-Hospital Vienna, 1100 Vienna, Austria.3rd Department and Karl Landsteiner, Institute for Metabolic Diseases and Nephrology, Clinic Hietzing, Vienna Health Care Group, 1130 Vienna, Austria.Department for Internal Medicine I, Medical University Innsbruck, 6020 Innsbruck, Austria.Clinical Division for Cardiology, Medical University Graz, 8036 Graz, Austria.Department for Internal Medicine I, Paracelsus Medical University, 5020 Salzburg, Austria.Division for Internal Medicine, Hospital Melk, 3390 Melk, Austria.3rd Department and Karl Landsteiner, Institute for Metabolic Diseases and Nephrology, Clinic Hietzing, Vienna Health Care Group, 1130 Vienna, Austria.Interdisciplinary Metabolic Medicine Trials Unit, Department of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria.Division for Internal Medicine, Hospital Melk, 3390 Melk, Austria.Clinical Division for Endocrinology and Diabetology and Metabolic Diseases, AKH Vienna, 1090 Vienna, Austria.3rd Department and Karl Landsteiner, Institute for Metabolic Diseases and Nephrology, Clinic Hietzing, Vienna Health Care Group, 1130 Vienna, Austria.Department for Exercise Physiology & Metabolism, University of Bayreuth, 95445 Bayreuth, Germany.Division for Internal Medicine, Hospital Stockerau, 2000 Stockerau, Austria.Department for Internal Medicine I, Medical University Innsbruck, 6020 Innsbruck, Austria.Interdisciplinary Metabolic Medicine Trials Unit, Department of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria.

Viruses. 2022;(6)

Abstract

BACKGROUND This study assessed the predictive performance of inflammatory, hepatic, coagulation, and cardiac biomarkers in patients with prediabetes and diabetes mellitus hospitalized for COVID-19 in Austria. METHODS This was an analysis of a multicenter cohort study of 747 patients with diabetes mellitus or prediabetes hospitalized for COVID-19 in 11 hospitals in Austria. The primary outcome of this study was in-hospital mortality. The predictor variables included demographic characteristics, clinical parameters, comorbidities, use of medication, disease severity, and laboratory measurements of biomarkers. The association between biomarkers and in-hospital mortality was assessed using simple and multiple logistic regression analyses. The predictive performance of biomarkers was assessed using discrimination and calibration. RESULTS In our analysis, 70.8% had type 2 diabetes mellitus, 5.8% had type 1 diabetes mellitus, 14.9% had prediabetes, and 8.6% had other types of diabetes mellitus. The mean age was 70.3 ± 13.3 years, and 69.3% of patients were men. A total of 19.0% of patients died in the hospital. In multiple logistic regression analysis, LDH, CRP, IL-6, PCT, AST-ALT ratio, NT-proBNP, and Troponin T were significantly associated with in-hospital mortality. The discrimination of NT-proBNP was 74%, and that of Troponin T was 81%. The calibration of NT-proBNP was adequate (p = 0.302), while it was inadequate for Troponin T (p = 0.010). CONCLUSION Troponin T showed excellent predictive performance, while NT-proBNP showed good predictive performance for assessing in-hospital mortality in patients with diabetes mellitus hospitalized with COVID-19. Therefore, these cardiac biomarkers may be used for prognostication of COVID-19 patients.

Methodological quality

Publication Type : Multicenter Study

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