Evidence map›Paper›PMID 36854893›Full record

Observational studyInfection2023

Diabetes mellitus is associated with 90-day mortality in old critically ill COVID-19 patients: a multicenter prospective observational cohort study.

Timo Mayerhöfer, Sebastian Klein, Bernhard Wernly, Hans Flaatten, Bertrand Guidet, Dylan W De Lange, Jesper Fjølner, Susannah Leaver, Michael Beil, Sigal Sviri and 11 more

Registry-linked trialOpen access · hybridAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Infection, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04321265 (Outcomes and Prognostic Factors in Coronavirus Disease), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.6field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04321265 unknown statusnot on this map

Outcomes and Prognostic Factors in Coronavirus Disease (COVID-19) in Very Old Intensive Care Patients

TypeobservationalSponsorHeinrich-Heine University, DuesseldorfRan2020 to 2023Enrolled1,500ConditionsCOVID-19, Elderly Patients, Critical Illness, Survival
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 15 institutions in 13 countries.

Timo MayerhöferDivision of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
Sebastian KleinDivision of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
Bernhard WernlyDepartment of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University Salzburg, Oberndorf, Salzburg, Austria.
Hans FlaattenDepartment of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.
Bertrand GuidetAssistance Publique, Hôpitaux de Paris, Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe: Epidémiologie Hospitalière Qualité et Organisation des Soins, 75012, Paris, France.
Dylan W De LangeDepartment of Intensive Care Medicine, University Medical Center, University Utrecht, Utrecht, The Netherlands.
Jesper FjølnerDepartment of Anaesthesia and Intensive Care, Viborg Regional Hospital, Viborg, Denmark.
Susannah LeaverDepartment of Critical Care, St George's Hospital, London, UK.
Michael BeilDepartment of Medical Intensive Care, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Sigal SviriDepartment of Medical Intensive Care, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Raphael Romano BrunoDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Moorenstraße 5, 40225, Duesseldorf, Germany.
Antonio ArtigasIntensive Intensive Care Medicine Department Corporacion Sanitària Parc Tauli CIBER Enfermedades Respiratorias Institut de Investigacio e Innovació I3PT, Autonomous University of Barcelona Sabadell, Sabadell, Spain.
Peter Vernon van HeerdenDepartment of Anesthesia, Intensive Care and Pain Medicine, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Bernardo Bollen PintoDepartment of Anaesthesiology, Pharmacology and Intensive Care, Geneva University Hospitals, Geneva, Switzerland.
Joerg C SchefoldDepartment of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Rui MorenoUnidade de Cuidados Intensivos Neurocríticos e Trauma, Hospital de São José, Centro Hospitalar Universitário de Lisboa Central, Faculdade de Ciências Médicas de Lisboa (Nova Médical School), Lisbon, Portugal.
Maurizio CecconiDepartment of Anesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center, IRCCS, Rozzano, MI, Italy.
Wojciech SzczeklikCenter for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Kraków, Poland.
Christian JungDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Moorenstraße 5, 40225, Duesseldorf, Germany.
Michael JoannidisDivision of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. michael.joannidis@i-med.ac.at.
COVIP study group
Hebrew University of Jerusalem · ILHeinrich Heine University Düsseldorf · DEInnsbruck Medical University · ATUniversity Medical Center Utrecht · NLUniversity of Bern · CHHospital de São José · PTSt George's Hospital · GBHaukeland University Hospital · NOHumanitas University · ITInserm · FRJagiellonian University · PLRegionshospitalet Viborg · DKUniversitat Autònoma de Barcelona · ESUniversity Hospital of Geneva · CHUniversity of Salzburg · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSeveral studies have found an association between diabetes mellitus, disease severity and outcome in COVID-19 patients. Old critically ill patients are particularly at risk. This study aimed to investigate the impact of diabetes mellitus on 90-day mortality in a high-risk cohort of critically ill patients over 70 years of age.

methodsThis multicentre international prospective cohort study was performed in 151 ICUs across 26 countries. We included patients ≥ 70 years of age with a confirmed SARS-CoV-2 infection admitted to the intensive care unit from 19th March 2020 through 15th July 2021. Patients were categorized into two groups according to the presence of diabetes mellitus. Primary outcome was 90-day mortality. Kaplan-Meier overall survival curves until day 90 were analysed and compared using the log-rank test. Mixed-effect Weibull regression models were computed to investigate the influence of diabetes mellitus on 90-day mortality.

resultsThis study included 3420 patients with a median age of 76 years were included. Among these, 37.3% (n = 1277) had a history of diabetes mellitus. Patients with diabetes showed higher rates of frailty (32% vs. 18%) and several comorbidities including chronic heart failure (20% vs. 11%), hypertension (79% vs. 59%) and chronic kidney disease (25% vs. 11%), but not of pulmonary comorbidities (22% vs. 22%). The 90-day mortality was significantly higher in patients with diabetes than those without diabetes (64% vs. 56%, p < 0.001). The association of diabetes and 90-day mortality remained significant (HR 1.18 [1.06-1.31], p = 0.003) after adjustment for age, sex, SOFA-score and other comorbidities in a Weibull regression analysis.

conclusionDiabetes mellitus was a relevant risk factor for 90-day mortality in old critically ill patients with COVID-19. STUDY REGISTRATION: NCT04321265, registered March 19th, 2020.

Indexed as

COVID-19Diabetes MellitusAgedAged, 80 and overCritical IllnessHumansIntensive Care UnitsProspective StudiesSARS-CoV-2Critical careElderlyIntensive care unitOldRisk factorsSARS-CoV-2Ventilation

Identifiers

PMID36854893
PMCPMC9974396
OpenAlexW4322621183

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.