TY - JOUR
T1 - Diabetes mellitus, glycaemic control, and severe COVID-19 in the Australian critical care setting
T2 - A nested cohort study
AU - Plummer, Mark
AU - Rait, Louise
AU - Finnis, Mark E.
AU - French, Craig J.
AU - Bates, Samantha
AU - Douglas, James
AU - Bhurani, Mansi
AU - Broadley, Tessa
AU - Trapani, Tony
AU - Deane, Adam M.
AU - Udy, Andrew A.
AU - Burrell, Aidan J.C.
AU - SPRINT-SARI Australia Investigators
AU - Visser, Adam
AU - Mattke, Adrian
AU - Regli, Adrian
AU - Rashid, Alan
AU - Tabah, Alexis
AU - Walker, Alison
AU - Cheng, Allen
AU - Corley, Amanda
AU - Ramnani, Anil
AU - Eidan, Anthony
AU - DeKeulenaer, Bart
AU - Reddi, Benjamin
AU - Richards, Brent
AU - Knott, Cameron
AU - Moore, Cara
AU - Delzoppo, Carmel
AU - Boschert, Catherine
AU - Tacon, Catherine
AU - Austin, Danielle
AU - Brewster, David
AU - Cooper, David
AU - Crosbie, David
AU - Hawkins, David
AU - Jessen, Edda
AU - Martinez, Eduardo
AU - Fysh, Edward
AU - Litton, Edward
AU - Oberender, Felix
AU - McGain, Forbes
AU - Salt, Gavin
AU - Eastwood, Glenn
AU - Taori, Gopal
AU - White, Hayden
AU - Buscher, Hergen
AU - Seppelt, Ian
AU - Leditschke, Isabel Anne
AU - Young, Janelle
AU - Lavana, Jayshree
AU - Cohen, Jeremy
AU - Lugsdin, Jessica
AU - Botha, John
AU - Santamaria, John
AU - Barrett, Jonathan
AU - Singh, Kasha
AU - Laupland, Kevin
AU - El-Khawas, Khaled
AU - Estensen, Kristine
AU - Deshpande, Kush
AU - White, Kyle
AU - Fitzpatrick, Leigh
AU - Campbell, Lewis
AU - Ramanan, Mahesh
AU - Saxena, Manoj
AU - Kainer, Marion
AU - Kol, Mark
AU - Page, Mark
AU - Sterba, Martin
AU - Anstey, Matthew
AU - Brain, Matthew
AU - Maiden, Matthew
AU - Kilminster, Myrene
AU - Hammond, Naomi
AU - Bhadange, Neeraj
AU - Humphreys, Nicole
AU - Jain, Paras
AU - Azzi, Paul
AU - Secombe, Paul
AU - Lister, Paula
AU - Chan, Peter
AU - McCanny, Peter
AU - Britton, Phillip
AU - Janin, Pierre
AU - Krishnamurthy, Ravi
AU - Sonawane, Ravikiran
AU - Tiruvoipati, Ravindranath
AU - Totaro, Richard
AU - Bellomo, Rinaldo
AU - Sanghavi, Ritesh
AU - Peake, Sandra
AU - Bihari, Shailesh
AU - George, Shane
AU - Erickson, Simon
AU - Webb, Steve
AU - Arora, Subhash
AU - Ganu, Subodh
AU - Rozen, Thomas
AU - McKenna, Toni
AU - Kadam, Umesh
AU - Nayyar, Vineet
AU - Choy, Wei Han
AU - Albassam, Wisam
PY - 2023/7
Y1 - 2023/7
N2 - Background: Internationally, diabetes mellitus is recognised as a risk factor for severe COVID-19. The relationship between diabetes mellitus and severe COVID-19 has not been reported in the Australian population. Objective: The objective of this study was to determine the prevalence of and outcomes for patients with diabetes admitted to Australian intensive care units (ICUs) with COVID-19. Methods: This is a nested cohort study of four ICUs in Melbourne participating in the Short Period Incidence Study of Severe Acute Respiratory Infection (SPRINT-SARI) Australia project. All adult patients admitted to the ICU with COVID-19 from 20 February 2020 to 27 February 2021 were included. Blood glucose and glycated haemoglobin (HbA1c) data were retrospectively collected. Diabetes was diagnosed from medical history or an HbA1c ≥6.5% (48 mmol/mol). Hospital mortality was assessed using logistic regression. Results: There were 136 patients with median age 58 years [48–68] and median Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 14 [11–19]. Fifty-eight patients had diabetes (43%), 46 patients had stress-induced hyperglycaemia (34%), and 32 patients had normoglycaemia (23%). Patients with diabetes were older, were with higher APACHE II scores, had greater glycaemic variability than patients with normoglycaemia, and had longer hospital length of stay. Overall hospital mortality was 16% (22/136), including nine patients with diabetes, nine patients with stress-induced hyperglycaemia, and two patients with normoglycaemia. Conclusion: Diabetes is prevalent in patients admitted to Australian ICUs with severe COVID-19, highlighting the need for prevention strategies in this vulnerable population.
AB - Background: Internationally, diabetes mellitus is recognised as a risk factor for severe COVID-19. The relationship between diabetes mellitus and severe COVID-19 has not been reported in the Australian population. Objective: The objective of this study was to determine the prevalence of and outcomes for patients with diabetes admitted to Australian intensive care units (ICUs) with COVID-19. Methods: This is a nested cohort study of four ICUs in Melbourne participating in the Short Period Incidence Study of Severe Acute Respiratory Infection (SPRINT-SARI) Australia project. All adult patients admitted to the ICU with COVID-19 from 20 February 2020 to 27 February 2021 were included. Blood glucose and glycated haemoglobin (HbA1c) data were retrospectively collected. Diabetes was diagnosed from medical history or an HbA1c ≥6.5% (48 mmol/mol). Hospital mortality was assessed using logistic regression. Results: There were 136 patients with median age 58 years [48–68] and median Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 14 [11–19]. Fifty-eight patients had diabetes (43%), 46 patients had stress-induced hyperglycaemia (34%), and 32 patients had normoglycaemia (23%). Patients with diabetes were older, were with higher APACHE II scores, had greater glycaemic variability than patients with normoglycaemia, and had longer hospital length of stay. Overall hospital mortality was 16% (22/136), including nine patients with diabetes, nine patients with stress-induced hyperglycaemia, and two patients with normoglycaemia. Conclusion: Diabetes is prevalent in patients admitted to Australian ICUs with severe COVID-19, highlighting the need for prevention strategies in this vulnerable population.
KW - Australia
KW - COVID-19
KW - Diabetes
KW - Stress hyperglycaemia
UR - http://www.scopus.com/inward/record.url?scp=85133800165&partnerID=8YFLogxK
U2 - 10.1016/j.aucc.2022.05.002
DO - 10.1016/j.aucc.2022.05.002
M3 - Article
C2 - 35820985
AN - SCOPUS:85133800165
SN - 1036-7314
VL - 36
SP - 579
EP - 585
JO - Australian Critical Care
JF - Australian Critical Care
IS - 4
ER -
