Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/31082
Title: Diabetes IN hospital - Glucose and Outcomes in the COVID-19 pandemic (DINGO COVID-19): the 2020 Melbourne hospital experience prior to novel variants and vaccinations.
Austin Authors: Barmanray, Rahul D;Gong, Joanna Y;Kyi, Mervyn;Kevat, Dev;Islam, Mohammad A;Galligan, Anna;Manos, Georgina R;Nair, Indu V;Perera, Nayomi;Adams, Nicholas K;Nursing, Ashvin;Warren, Annabelle M;Hamblin, Peter S;MacIsaac, Richard J;Ekinci, Elif I ;Krishnamurthy, Balasubramanian;Karunajeewa, Harin;Buising, Kirsty;Visvanathan, Kumar;Kay, Thomas W H;Fourlanos, Spiros
Affiliation: St Vincent's Institute, Melbourne, Victoria, Australia
Department of Medicine, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
Department of Endocrinology, Northern Health, Melbourne, Victoria, Australia
Department of Medicine, Western Health, The University of Melbourne, Melbourne, Victoria, Australia
Department of Medicine, St Vincent's Hospital, The University of Melbourne, Melbourne, Victoria, Australia
General Internal Medicine Unit, Western Health, Melbourne, Victoria, Australia
Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia
Department of Infectious Diseases, The University of Melbourne, Melbourne, Victoria, Australia
Department of Diabetes & Endocrinology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
Department of Endocrinology & Diabetes, Western Health, Melbourne, Victoria, Australia
Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
Australian Centre for Accelerating Diabetes Innovations (ACADI), The University of Melbourne, Melbourne, Victoria, Australia
Department of Endocrinology & Diabetes, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
Department of Diabetes, Monash Health, Melbourne, Victoria, Australia
Endocrinology
Issue Date: 2023
Date: 2022
Publication information: Internal Medicine Journal 2023; 53(1)
Abstract: A relationship between diabetes, glucose and COVID-19 outcomes has been reported in international cohorts. This study aimed to assess the relationship between diabetes, hyperglycaemia and patient outcomes in those hospitalised with COVID-19 during the first year of the Victorian pandemic prior to novel variants and vaccinations. Retrospective cohort study from March to November 2020 across five public health services in Melbourne, Australia. All consecutive adult patients admitted to acute wards of participating institutions during the study period with a diagnosis of COVID-19, comprising a large proportion of patients from residential care facilities and following dexamethasone becoming standard-of-care. Admissions in patients without known diabetes and without inpatient glucose testing were excluded. The DINGO COVID-19 cohort comprised 840 admissions. In 438 admissions (52%), there was no known diabetes or in-hospital hyperglycaemia, in 298 (35%) patients had known diabetes, and in 104 (12%) patients had hyperglycaemia without known diabetes. ICU admission was more common in those with diabetes (20%) and hyperglycaemia without diabetes (49%) than those with neither (11%, P < 0.001 for all comparisons). Mortality was higher in those with diabetes (24%) than those without diabetes or hyperglycaemia (16%, P = 0.02) but no difference between those with in-hospital hyperglycaemia and either of the other groups. On multivariable analysis, hyperglycaemia was associated with increased ICU admission (adjusted odds ratio (aOR) 6.7, 95% confidence interval (95% CI) 4.0-12, P < 0.001) and longer length of stay (aOR 173, 95% CI 11-2793, P < 0.001), while diabetes was associated with reduced ICU admission (aOR 0.55, 95% CI 0.33-0.94, P = 0.03). Neither diabetes nor hyperglycaemia was independently associated with in-hospital mortality. During the first year of the COVID-19 pandemic, in-hospital hyperglycaemia and known diabetes were not associated with in-hospital mortality, contrasting with published international experiences. This likely mainly relates to hyperglycaemia indicating receipt of mortality-reducing dexamethasone therapy. These differences in published experiences underscore the importance of understanding population and clinical treatment factors affecting glycaemia and COVID-19 morbidity within both local and global contexts.
URI: https://ahro.austin.org.au/austinjspui/handle/1/31082
DOI: 10.1111/imj.15937
ORCID: 0000-0002-1433-2239
0000-0002-4341-8250
0000-0002-6280-865X
0000-0003-2372-395X
0000-0002-5786-1448
Journal: Internal Medicine Journal
PubMed URL: 36269315
Type: Journal Article
Appears in Collections:Journal articles

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