Introduction
Methods
Results
Clinical features | Number of people with available data | All | Primary outcome (n = 382) OR (95% CI) | Death (n = 140) OR (95% CI) |
---|---|---|---|---|
Sex (female/male) | 1317 | 462/1317 (35.1) | 0.77 (0.60, 0.99) | 0.80 (0.55, 1.17) |
Age (years)a | 1317 | 69.8 ± 13.0 | 1.00 (0.99, 1.01) | 1.09 (1.07, 1.11) |
Age class (years) | 1317 | |||
<55 | 159/1317 (12.1) | 1 | 1 | |
55–64 | 266/1317 (20.2) | 0.58 (0.38, 0.90) | 1.00 (0.23, 4.23) | |
65–74 | 394/1317 (29.9) | 0.89 (0.60, 1.31) | 3.22 (0.95, 10.1) | |
≥75 | 498/1317 (37.8) | 0.85 (0.58, 1.24) | 14.6 (4.56, 46.6) | |
Type of diabetes | 1317 | |||
Type 2 | 1166/1317 (88.5) | 1 | 1 | |
Type 1 | 39/1317 (3.0) | 0.73 (0.35, 1.56) | 0.44 (0.11, 1.86) | |
Other | 71/1317 (5.4) | 1.33 (0.80, 2.20) | 1.50 (0.77, 2.93) | |
Diagnosed on admission | 41/1317 (3.1) | 0.79 (0.38, 1.63) | – | |
Ethnicity | 1035 | |||
EU | 641/1035 (61.9) | 1 | 1 | |
MENA | 196/1035 (18.9) | 0.98 (0.69, 1.40) | 0.87 (0.52, 1.47) | |
AC | 174/1035 (16.8) | 0.96 (0.66, 1.40) | 0.78 (0.44, 1.37) | |
AS | 24/1035 (2.3) | 1.51 (0.65, 3.52) | – | |
BMI (kg/m2)a | 1117 | 28.4 [25.0–32.7] | 1.25 (1.09, 1.42) | 0.95 (0.78, 1.16) |
BMI class | 1117 | |||
<25 kg/m2 | 279/1117 (25) | 1 | 1 | |
25–29.9 kg/m2 | 410/1117 (36.7) | 1.33 (0.93, 1.89) | 0.70 (0.42, 1.16) | |
30–39.9 kg/m2 | 359/1117 (32.1) | 1.71 (1.20, 2.43) | 0.76 (0.45, 1.27) | |
≥40 kg/m2 | 69/1117 (6.2) | 1.28 (0.70, 2.32) | 0.74 (0.29, 1.84) | |
Diabetes duration (years) | 772 | 13.6 ± 10.9 | 1.00 (0.98, 1.01) | 1.01 (0.99, 1.04) |
HbA1c (mmol/mol)a | 846 | 65.4 ± 21.2 | 0.99 (0.99, 1.00) | 1.00 (0.99, 1.02) |
HbA1c (%)a | 846 | 8.1 ± 1.9 | 0.94 (0.86, 1.03) | 1.02 (0.87, 1.19) |
HbA1c (categories) | 846 | |||
<53 mmol/mol (7%) | 245/846 (29.0) | 1 | 1 | |
53–63 mmol/mol (7–7.9%) | 228/846 (27.0) | 0.84 (0.55, 1.27) | 1.55 (0.82, 2.93) | |
64–74 mmol/mol (8–8.9%) | 164/846 (19.4) | 0.92 (0.59, 1.45) | 1.09 (0.52, 2.28) | |
≥75 mmol/mol (9%) | 209/846 (24.7) | 0.78 (0.51, 1.21) | 0.84 (0.40, 1.75) | |
Hypertension | 1299 | 1003/1299 (77.2) | 1.23 (0.92, 1.65) | 1.82 (1.11, 2.98) |
Dyslipidaemia | 1255 | 640/1255 (51.0) | 1.07 (0.84, 1.37) | 1.21 (0.84, 1.74) |
Tobacco use | 1029 | |||
Never | 582/1029 (56.6) | 1 | 1 | |
Former | 390/1029 (37.9) | 1.21 (0.91, 1.61) | 1.00 (0.64, 1.57) | |
Current | 57/1029 (5.5) | 1.54 (0.87, 2.74) | 1.20 (0.49, 2.93) | |
Long, term diabetes complications | ||||
Microvascular complications | 883 | 413/883 (46.8) | 1.28 (0.94, 1.73) | 5.25 (3.03, 9.10) |
Severe diabetic retinopathy | 954 | 66/954 (6.9) | 1.22 (0.71, 2.11) | 2.05 (1.03, 4.07) |
Diabetic kidney disease | 1066 | 355/1066 (33.3) | 1.03 (0.78, 1.37) | 3.19 (2.09, 4.87) |
History of diabetic foot ulcer | 1232 | 76/1232 (6.2) | 0.67 (0.38, 1.18) | 1.53 (0.79, 2.99) |
Macrovascular complications | 1189 | 485/1189 (40.8) | 1.18 (0.91, 1.52) | 3.58 (2.41, 5.31) |
Ischaemic heart disease (ACS/CAR) | 1251 | 336/1251 (26.9) | 1.04 (0.79, 1.37) | 2.65 (1.84, 3.82) |
Cerebrovascular disease (stroke or TIA) | 1267 | 163/1267 (12.9) | 1.02 (0.71, 1.47) | 2.19 (1.4, 3.42) |
Peripheral artery disease (major amputation/LLAR) | 1285 | 145/1285 (11.3) | 0.91 (0.61, 1.34) | 1.97 (1.23, 3.17) |
Comorbidities | ||||
Heart failure | 1206 | 140/1206 (11.6) | 0.78 (0.52, 1.17) | 2.28 (1.42, 3.66) |
NAFLD or liver cirrhosis | 1107 | 119/1107 (10.7) | 1.23 (0.81, 1.86) | 0.70 (0.34, 1.41) |
Active cancer | 1282 | 194/1282 (15.1) | 1.08 (0.77, 1.50) | 1.55 (0.99, 2.42) |
COPD | 1278 | 133/1278 (10.4) | 0.96 (0.64, 1.43) | 1.36 (0.80, 2.32) |
Treated OSA | 1189 | 144/1189 (12.1) | 1.44 (0.99, 2.08) | 1.81 (1.12, 2.93) |
Organ graft | 1302 | 38/1302 (2.9) | 1.14 (0.57, 2.28) | 0.46 (0.11, 1.93) |
End stage renal failure | 831 | 60/831 (7.2) | 0.66 (0.35, 1.27) | 0.62 (0.24, 1.60) |
Routine treatment before admission | ||||
Metformin | 1317 | 746/1317 (56.6) | 0.95 (0.75, 1.21) | 0.59 (0.42, 0.84) |
Sulfonylurea/glinides | 1317 | 367/1317 (27.9) | 1.03 (0.79, 1.34) | 0.74 (0.49, 1.13) |
DPP-4 inhibitors | 1317 | 285/1317 (21.6) | 1.01 (0.75, 1.34) | 0.85 (0.55, 1.32) |
GLP1-RA | 1317 | 123/1317 (9.3) | 1.36 (0.92, 2.01) | 0.64 (0.32, 1.29) |
Insulin | 1317 | 504/1317 (38.3) | 1.01 (0.79, 1.29) | 1.71 (1.20, 2.43) |
Loop diuretics | 1317 | 252/1317 (19.1) | 1.10 (0.81, 1.48) | 2.49 (1.70, 3.64) |
Thiazide diuretics | 1317 | 267/1317 (20.3) | 1.08 (0.81, 1.45) | 0.98 (0.63, 1.52) |
Potassium-sparing diuretics | 1317 | 59/1317 (4.5) | 1.17 (0.67, 2.05) | 1.77 (0.88, 3.58) |
MRA | 1317 | 53/1317 (4.0) | 0.96 (0.52, 1.78) | 2.03 (1.00, 4.13) |
β-blockers | 1317 | 442/1317 (33.6) | 1.03 (0.80, 1.32) | 1.84 (1.29, 2.62) |
ACE inhibitors | 1317 | 354/1317 (26.9) | 1.17 (0.90, 1.52) | 1.43 (0.99, 2.08) |
ARBs | 1317 | 389/1317 (29.5) | 1.22 (0.94, 1.57) | 1.15 (0.79, 1.67) |
ARBs and/or ACE inhibitors | 1317 | 737/1317 (56.0) | 1.32 (1.03, 1.68) | 1.58 (1.09, 2.28) |
ARBs and/or ACE inhibitors and/or MRA | 1317 | 752/1317 (57.1) | 1.29 (1.01, 1.65) | 1.67 (1.15, 2.43) |
Statins | 1317 | 627/1317 (47.6) | 1.03 (0.81, 1.31) | 1.19 (0.84, 1.68) |
Characteristic | Number of people with available data | All | Primary outcome (n = 382) OR (95% CI) | Death (n = 140) OR (95% CI) |
---|---|---|---|---|
COVID-19 symptoms | 1313 | 1237/1313 (94.2) | 3.20 (1.58, 6.49) | 2.21 (0.79, 6.13) |
Time between symptom onset and hospital admission (days) | 1302 | 5 [2–8] | 1.01 (0.99, 1.03) | 0.96 (0.92, 0.99) |
Clinical presentation | ||||
Fever | 1288 | 1003/1288 (77.9) | 1.07 (0.80, 1.44) | 0.73 (0.49, 1.10) |
Fatigue | 1239 | 773/1239 (62.4) | 1.15 (0.89, 1.49) | 1.13 (0.77, 1.65) |
Cough | 1270 | 872/1270 (68.7) | 0.99 (0.76, 1.29) | 0.87 (0.59, 1.28) |
Cephalalgia | 1193 | 157/1193 (13.2) | 0.85 (0.58, 1.25) | 0.44 (0.21, 0.92) |
Dyspnoea | 1292 | 798/1292 (61.8) | 2.56 (1.95, 3.36) | 2.29 (1.51, 3.47) |
Rhinitis and/or pharyngeal symptoms | 1178 | 111/1178 (9.4) | 0.78 (0.49, 1.23) | 0.39 (0.16, 0.99) |
Ageusia and/or anosmia | 1073 | 136/1073 (12.7) | 0.73 (0.47, 1.12) | 0.34 (0.14, 0.85) |
Digestive disorders | 1236 | 427/1236 (34.5) | 0.83 (0.64, 1.08) | 0.88 (0.60, 1.30) |
Chest CT imaging | ||||
Abnormal chest CT | 896 | 844/896 (94.2) | 1.16 (0.61, 2.21) | – |
Ground-glass opacity/crazy paving | 818 | 736/818 (90.0) | 1.83 (1.02, 3.28) | 1.70 (0.66, 4.32) |
Biological findings | ||||
Positive SARS-CoV-2 PCR | 1268 | 1227/1268 (96.8) | 2.44 (1.02, 5.85) | 1.54 (0.47, 5.06) |
Admission plasma glucose (mmol/l)a | 940 | 9.20 [6.80–12.62] | 1.28 (1.12, 1.48) | 1.20 (0.98, 1.46) |
Plasma creatinine (μmol/l)a | 1196 | 91 [69–133] | 1.24 (1.10, 1.40) | 1.56 (1.33, 1.82) |
eGFR (ml min−1 [1.73 m]−2)a | 1196 | 69 [41.7–89.5] | 0.82 (0.73, 0.93) | 0.61 (0.52, 0.71) |
ALT (%ULN)a | 1068 | 0.62 [0.41–0.99] | 1.25 (1.10, 1.42) | 0.84 (0.67, 1.06) |
AST (%ULN)a | 1053 | 1.05 [0.75–1.51] | 1.78 (1.54, 2.06) | 1.34 (1.14, 1.59) |
GGT (%ULN)a | 983 | 0.94 [0.56–1.73] | 1.25 (1.10, 1.43) | 0.97 (0.78, 1.20) |
Haemoglobin (g/l)a | 1276 | 129 [114–143] | 0.95 (0.84, 1.07) | 0.96 (0.81, 1.14) |
White cell count (103/mm3)a | 1269 | 6440 [4930–8610] | 1.27 (1.12, 1.44) | 1.43 (1.19, 1.70) |
Lymphocyte count (103/mm3)a | 1211 | 990 [685–1400] | 0.69 (0.60, 0.80) | 0.75 (0.60, 0.92) |
Platelet count (103/mm3)a | 1273 | 193 [151–246] | 0.86 (0.76, 0.97) | 0.86 (0.73, 1.02) |
D-dimers (μg/l)a | 397 | 830 [350–1571] | 0.93 (0.76, 1.15) | 1.25 (0.84, 1.86) |
CRP (mg/l)a | 1208 | 77.8 [38.4–132.7] | 1.99 (1.69, 2.34) | 1.49 (1.20, 1.84) |
LDH (UI/l)a | 566 | 351 [268–496] | 2.43 (1.85, 3.18) | 1.62 (1.10, 2.39) |
CPK (UI/l)a | 549 | 145 [72–319] | 1.56 (1.30, 1.88) | 1.68 (1.31, 2.17) |
Fibrinogen (g/l)a | 658 | 6.0 [4.8–7.2] | 1.32 (1.09, 1.58) | 1.05 (0.84, 1.31) |
Model ‘prior to admission’: fully adjusted | Model ‘prior to admission’: stepwise selection with age and sex forced | |||
---|---|---|---|---|
Patient characteristics | OR (95% CI) | p value | OR (95% CI) | p value |
Age (+1 SD) | 1.05 (0.90, 1.21) | 0.5495 | 1.06 (0.92, 1.22) | 0.4448 |
Sex (female/male) | 0.76 (0.57, 1.03) | 0.0777 | 0.75 (0.56, 1.01) | 0.0559 |
BMI (+1 SD) | 1.24 (1.06, 1.44) | 0.0064 | 1.28 (1.10, 1.47) | 0.0010 |
Treated OSA | 1.15 (0.76, 1.73) | 0.5036 | – | – |
ARBs and/or ACE inhibitors and/or MRAs | 1.15 (0.86, 1.54) | 0.3493 | – | – |
Model ‘prior to admission’: fully adjusted | Model ‘prior to admission’: stepwise selection with age and sex forced | |||
---|---|---|---|---|
Patient characteristics | OR (95% CI) | p value | OR (95% CI) | p value |
Age (+1 SD) | 2.39 (1.67, 3.42) | <0.0001 | 2.48 (1.74, 3.53) | <0.0001 |
Sex (female/male) | 0.78 (0.43, 1.40) | 0.4023 | 0.78 (0.44, 1.38) | 0.4007 |
Hypertension | 0.76 (0.34, 1.70) | 0.5087 | – | – |
Microvascular complications | 1.78 (0.92, 3.44) | 0.0846 | 2.14 (1.16, 3.94) | 0.0153 |
Macrovascular complications | 2.26 (1.25, 4.08) | 0.0069 | 2.54 (1.44, 4.50) | 0.0013 |
Heart failure | 1.08 (0.54, 2.15) | 0.8249 | – | – |
Active cancer | 1.45 (0.77, 2.73) | 0.2458 | – | – |
Treated OSA | 2.65 (1.36, 5.19) | 0.0044 | 2.80 (1.46, 5.38) | 0.0020 |
β-Blockers | 1.19 (0.69, 2.06) | 0.5321 | – | – |
Metformin | 0.80 (0.45, 1.43) | 0.4532 | – | – |
Insulin | 1.26 (0.72, 2.22) | 0.4130 | – | – |
Loop diuretics | 1.39 (0.76, 2.55) | 0.2806 | – | – |
ARBs and/or ACE inhibitors and/or MRAs | 1.22 (0.68, 2.20) | 0.5069 | – | – |
Model ‘on admission’: fully adjusted | Model ‘on admission’: stepwise selection with age and sex forced | |||
---|---|---|---|---|
Patient characteristics | OR (95% CI) | p value | OR (95% CI) | p value |
Age (+1 SD) | 0.98 (0.77, 1.25) | 0.8569 | 1.02 (0.81, 1.28) | 0.8981 |
Sex (female/male) | 1.46 (0.88, 2.41) | 0.1410 | 1.44 (0.89, 2.32) | 0.1417 |
BMI (+1 SD) | 1.13 (0.89, 1.43) | 0.3297 | – | – |
Dyspnoea | 2.17 (1.34, 3.50) | 0.0015 | 2.10 (1.31, 3.35) | 0.0020 |
Admission plasma glucose (+1 SD) | 1.14 (0.92, 1.42) | 0.2391 | – | – |
eGFR (+1 SD) | 0.81 (0.64, 1.01) | 0.0643 | – | – |
AST (+1 SD) | 2.19 (1.65, 2.90) | <0.0001 | 2.23 (1.70, 2.93) | <0.0001 |
Lymphocyte count (+1 SD) | 0.70 (0.53, 0.94) | 0.0161 | 0.67 (0.50, 0.88) | 0.0050 |
Platelet count (+1 SD) | 0.80 (0.63, 1.01) | 0.0623 | – | – |
CRP (+1 SD) | 2.00 (1.47, 2.73) | <0.0001 | 1.93 (1.43, 2.59) | <0.0001 |
Model ‘clinical and biological’: fully adjusted | Model ‘clinical and biological’: stepwise selection with age and sex forced | |||
---|---|---|---|---|
Patient characteristics | OR (95% CI) | p value | OR (95% CI) | p value |
Age (+1 SD) | 4.28 (2.64, 6.94) | <0.0001 | 4.12 (2.59, 6.55) | <0.0001 |
Sex (female/male) | 0.92 (0.44, 1.92) | 0.8237 | 1.02 (0.50, 2.09) | 0.9523 |
Cephalalgia | 1.55 (0.43, 5.58) | 0.5029 | – | – |
Dyspnoea | 2.73 (1.30, 5.73) | 0.0079 | 2.80 (1.37, 5.72) | 0.0049 |
Rhinitis and/or pharyngeal signs | 0.46 (0.11, 1.96) | 0.2957 | – | – |
Ageusia and/or anosmia | 1.31 (0.43, 4.01) | 0.6403 | – | – |
Admission plasma glucose (log, +1 SD) | 1.30 (0.94, 1.82) | 0.1148 | – | – |
eGFR (log, +1 SD) | 0.51 (0.37, 0.69) | <0.0001 | 0.51 (0.38, 0.69) | <0.0001 |
AST (log, +1 SD) | 1.93 (1.38, 2.71) | 0.0001 | 1.85 (1.33, 2.56) | 0.0003 |
White cell count (log, +1 SD) | 1.29 (0.86, 1.92) | 0.2126 | – | – |
Platelet count (log, +1 SD) | 0.66 (0.47, 0.92) | 0.0144 | 0.71 (0.53, 0.97) | 0.0292 |
CRP (log, +1 SD) | 1.70 (1.09, 2.66) | 0.0202 | 1.87 (1.20, 2.89) | 0.0052 |