PT  - JOURNAL ARTICLE
AU  - Chioma Izzi-Engbeaya
AU  - Walter Distaso
AU  - Anjali Amin
AU  - Wei Yang
AU  - Oluwagbemiga Idowu
AU  - Julia S Kenkre
AU  - Ronak J Shah
AU  - Evelina Woin
AU  - Christine Shi
AU  - Nael Alavi
AU  - Hala Bedri
AU  - Niamh Brady
AU  - Sophie Blackburn
AU  - Martina Leczycka
AU  - Sanya Patel
AU  - Elizaveta Sokol
AU  - Edward Toke-Bjolgerud
AU  - Ambreen Qayum
AU  - Mariana Abdel-Malek
AU  - David C D Hope
AU  - Nick S Oliver
AU  - Vasiliki Bravis
AU  - Shivani Misra
AU  - Tricia M Tan
AU  - Neil E Hill
AU  - Victoria Salem
TI  - Adverse outcomes in COVID-19 and diabetes: a retrospective cohort study from three London teaching hospitals
AID  - 10.1136/bmjdrc-2020-001858
DP  - 2021 Jan 01
TA  - BMJ Open Diabetes Research & Care
PG  - e001858
VI  - 9
IP  - 1
4099  - http://drc.bmj.com/content/9/1/e001858.short
4100  - http://drc.bmj.com/content/9/1/e001858.full
SO  - BMJ Open Diab Res Care2021 Jan 01; 9
AB  - Introduction Patients with diabetes mellitus admitted to hospital with COVID-19 have poorer outcomes. However, the drivers of poorer outcomes are not fully elucidated. We performed detailed characterization of patients with COVID-19 to determine the clinical and biochemical factors that may be drivers of poorer outcomes.Research design and methods This is a retrospective cohort study of 889 consecutive inpatients diagnosed with COVID-19 between March 9 and April 22, 2020 in a large London National Health Service Trust. Unbiased multivariate logistic regression analysis was performed to determine variables that were independently and significantly associated with increased risk of death and/or intensive care unit (ICU) admission within 30 days of COVID-19 diagnosis.Results 62% of patients in our cohort were of non-white ethnic background and the prevalence of diabetes was 38%. 323 (36%) patients met the primary outcome of death/admission to the ICU within 30 days of COVID-19 diagnosis. Male gender, lower platelet count, advancing age and higher Clinical Frailty Scale (CFS) score (but not diabetes) independently predicted poor outcomes on multivariate analysis. Antiplatelet medication was associated with a lower risk of death/ICU admission. Factors that were significantly and independently associated with poorer outcomes in patients with diabetes were coexisting ischemic heart disease, increasing age and lower platelet count.Conclusions In this large study of a diverse patient population, comorbidity (ie, diabetes with ischemic heart disease; increasing CFS score in older patients) was a major determinant of poor outcomes with COVID-19. Antiplatelet medication should be evaluated in randomized clinical trials among high-risk patient groups.