Cardiometabolic therapy and mortality in very old patients with diabetes hospitalized due to COVID-19

Jose Manuel Ramos-Rincón; Luis M Pérez-Belmonte; Francisco Javier Carrasco-Sánchez; Sergio Jansen-Chaparro; Mercedes De-Sousa-Baena; José Bueno-Fonseca; Maria Pérez-Aguilar; Coral Arévalo-Cañas; Marta Bacete Cebrian; Manuel Méndez-Bailón; Isabel Fiteni Mera; Andrés González García; Francisco Navarro Romero; Carlota Tuñón de Almeida; Gemma Muñiz Nicolás; Amara González Noya; Almudena Hernández Milian; Gema María García García; José Nicolás Alcalá Pedrajas; Virginia Herrero García; Luis Corral-Gudino; Pere Comas Casanova; Héctor Meijide Míguez; José Manuel Casas-Rojo; Ricardo Gómez-Huelgas; for the SEMI-COVID-19 Network

doi:10.1093/gerona/glab124

. 2021 May 4:glab124. doi: 10.1093/gerona/glab124

Cardiometabolic therapy and mortality in very old patients with diabetes hospitalized due to COVID-19

Jose Manuel Ramos-Rincón ^1,^#, Luis M Pérez-Belmonte ^2,^✉, Francisco Javier Carrasco-Sánchez ³, Sergio Jansen-Chaparro ², Mercedes De-Sousa-Baena ³, José Bueno-Fonseca ², Maria Pérez-Aguilar ³, Coral Arévalo-Cañas ⁴, Marta Bacete Cebrian ⁵, Manuel Méndez-Bailón ⁶, Isabel Fiteni Mera ⁷, Andrés González García ⁸, Francisco Navarro Romero ⁹, Carlota Tuñón de Almeida ¹⁰, Gemma Muñiz Nicolás ¹¹, Amara González Noya ¹², Almudena Hernández Milian ¹³, Gema María García García ¹⁴, José Nicolás Alcalá Pedrajas ¹⁵, Virginia Herrero García ¹⁶, Luis Corral-Gudino ¹⁷, Pere Comas Casanova ¹⁸, Héctor Meijide Míguez ¹⁹, José Manuel Casas-Rojo ²⁰, Ricardo Gómez-Huelgas ^2,^#; for the SEMI-COVID-19 Network¹

¹Department of Clinical Medicine, Miguel Hernandez University of Elche, Alicante, Spain

²Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), Málaga, Spain

³Internal Medicine Department. Juan Ramón Jiménez University Hospital, Huelva, Spain

⁴Internal Medicine Department, 12 de Octubre University Hospital, Madrid, Spain

⁵Internal Medicine Department, Gregorio Marañon University Hospital, Madrid, Spain

⁶Internal Medicine Department, San Carlos Clinical Hospital, Complutense University, Madrid, Spain

⁷Internal Medicine Department, Royo Villanova Hospital, Zaragoza, Spain

⁸Internal Medicine Department, Ramón y Cajal University Hospital, Madrid, Spain

⁹Internal Medicine Department, Costa del Sol Hospital, Marbella (Málaga), Spain

¹⁰Internal Medicine Department, Zamora Hospital Complex, Zamora, Spain

¹¹Internal Medicine Department, Virgen de la Salud Hospital, Toledo, Spain

¹²Internal Medicine Department, Ourense University Hospital Complex, Ourense, Spain

¹³Internal Medicine Department, Son Llàtzer University Hospital, Palma de Mallorca, Spain

¹⁴Internal Medicine Department, Badajoz University Hospital Complex, Badajoz, Spain

¹⁵Internal Medicine Department, Pozoblanco Hospital, Pozoblanco (Córdoba), Spain

¹⁶Internal Medicine Department, Doctor José Molina Orosa Hospital, Arrecife (Lanzarote), Spain

¹⁷Internal Medicine Department, Río Hortega University Hospital, Regional Health Management of Castilla y Leon (SACYL), Valladolid University, Valladolid, Spain

¹⁸Internal Medicine Department, Blanes Hospital, Blanes (Girona), Spain

¹⁹Internal Medicine Department, Quironsalud A Coruña Hospital, A Coruña, Spain

²⁰Internal Medicine Department. Infanta Cristina University Hospital, Parla (Madrid), Spain

These authors have contributed equally to this work.

^✉

Corresponding authors information: Luis M. Pérez-Belmonte. Address: Servicio de Medicina Interna, Hospital Regional Universitario de Málaga. Avenida de Carlos Haya, s/n, 29010, Málaga, Spain. Telephone number: 0034 951 291 169. Fax number: 0034 951 290 006. E-mail address: luismiguelpb1984@gmail.com.

PMCID: PMC8135901 PMID: 33945610

Abstract

Background

The effects of cardiometabolic drugs on the prognosis of diabetic patients with COVID-19, especially very old patients, are not well-known. This work aims to analyze the association between preadmission cardiometabolic therapy (antidiabetic, antiaggregant, antihypertensive, and lipid-lowering drugs) and in-hospital mortality among patients ≥80 years with type 2 diabetes mellitus hospitalized for COVID-19.

Methods

We conducted a nationwide, multicenter, observational study in patients ≥80 years with type 2 diabetes mellitus hospitalized for COVID-19 between March 1 and May 29, 2020. The primary outcome measure was in-hospital mortality. A multivariate logistic regression analysis were performed to assess the association between preadmission cardiometabolic therapy and in-hospital mortality.

Results

Of the 2,763 patients ≥80 years old hospitalized due to COVID-19, 790 (28.6%) had T2DM. Of these patients, 385 (48.7%) died during admission. On the multivariate analysis, the use of dipeptidyl peptidase-4 inhibitors (AOR 0.502, 95%CI 0.309-0.815, p=0.005) and angiotensin receptor blockers (AOR 0.454, 95%CI 0.274-0.759, p=0.003) were independent protectors against in-hospital mortality whereas the use of acetylsalicylic acid was associated with higher in-hospital mortality (AOR 1.761, 95%CI 1.092-2.842, p=0.020). Other antidiabetic drugs, angiotensin-converting enzyme inhibitors and statins showed neutral association with in-hospital mortality.

Conclusions

We found important differences between cardiometabolic drugs and in-hospital mortality in older patients with type 2 diabetes mellitus hospitalized for COVID-19. Preadmission treatment with dipeptidyl peptidase-4 inhibitors and angiotensin receptor blockers could reduce in-hospital mortality; other antidiabetic drugs, angiotensin-converting enzyme inhibitors and statins seem to have a neutral effect; and acetylsalicylic acid could be associated with excess mortality.

Keywords: age ≥80, type 2 diabetes, coronavirus disease-2019, mortality, cardiometabolic therapy

PERMALINK

Cardiometabolic therapy and mortality in very old patients with diabetes hospitalized due to COVID-19

Jose Manuel Ramos-Rincón, MD PhD

Luis M Pérez-Belmonte, MD PhD

Francisco Javier Carrasco-Sánchez, MD PhD

Sergio Jansen-Chaparro, MD PhD

Mercedes De-Sousa-Baena, MD

José Bueno-Fonseca, MD

Maria Pérez-Aguilar, MD

Coral Arévalo-Cañas, MD

Marta Bacete Cebrian, MD

Manuel Méndez-Bailón, MD PhD

Isabel Fiteni Mera, MD, PhD

Andrés González García, MD PhD

Francisco Navarro Romero, MD PhD

Carlota Tuñón de Almeida, MD

Gemma Muñiz Nicolás, MD

Amara González Noya, MD

Almudena Hernández Milian, MD

Gema María García García, MD

José Nicolás Alcalá Pedrajas, MD

Virginia Herrero García, MD

Luis Corral-Gudino, MD PhD

Pere Comas Casanova, MD

Héctor Meijide Míguez, MD PhD

José Manuel Casas-Rojo, MD

Ricardo Gómez-Huelgas, MD PhD

Abstract

Background

Methods

Results

Conclusions

ACTIONS

PERMALINK

RESOURCES

Cite

Add to Collections

PERMALINK

Cardiometabolic therapy and mortality in very old patients with diabetes hospitalized due to COVID-19

Jose Manuel Ramos-Rincón, MD PhD

Luis M Pérez-Belmonte, MD PhD

Francisco Javier Carrasco-Sánchez, MD PhD

Sergio Jansen-Chaparro, MD PhD

Mercedes De-Sousa-Baena, MD

José Bueno-Fonseca, MD

Maria Pérez-Aguilar, MD

Coral Arévalo-Cañas, MD

Marta Bacete Cebrian, MD

Manuel Méndez-Bailón, MD PhD

Isabel Fiteni Mera, MD, PhD

Andrés González García, MD PhD

Francisco Navarro Romero, MD PhD

Carlota Tuñón de Almeida, MD

Gemma Muñiz Nicolás, MD

Amara González Noya, MD

Almudena Hernández Milian, MD

Gema María García García, MD

José Nicolás Alcalá Pedrajas, MD

Virginia Herrero García, MD

Luis Corral-Gudino, MD PhD

Pere Comas Casanova, MD

Héctor Meijide Míguez, MD PhD

José Manuel Casas-Rojo, MD

Ricardo Gómez-Huelgas, MD PhD

Abstract

Background

Methods

Results

Conclusions

ACTIONS

PERMALINK

RESOURCES

Similar articles

Cited by other articles

Links to NCBI Databases