Predictors of hospital discharge and mortality in patients with diabetes and COVID-19: updated results from the nationwide CORONADO study

AIMS/HYPOTHESIS: This is an update of the results from the previous report of the CORONADO (Coronavirus SARS-CoV-2 and Diabetes Outcomes) study, which aims to describe the outcomes and prognostic factors in patients with diabetes hospitalised for coronavirus disease-2019 (COVID-19). METHODS: The CORONADO initiative is a French nationwide multicentre study of patients with diabetes hospitalised for COVID-19 with a 28-day follow-up. The patients were screened after hospital admission from 10 March to 10 April 2020. We mainly focused on hospital discharge and death within 28 days. RESULTS: We included 2796 participants: 63.7% men, mean age 69.7 ± 13.2 years, median BMI (25th-75th percentile) 28.4 (25.0-32.4) kg/m(2). Microvascular and macrovascular diabetic complications were found in 44.2% and 38.6% of participants, respectively. Within 28 days, 1404 (50.2%; 95% CI 48.3%, 52.1%) were discharged from hospital with a median duration of hospital stay of 9 (5-14) days, while 577 participants died (20.6%; 95% CI 19.2%, 22.2%). In multivariable models, younger age, routine metformin therapy and longer symptom duration on admission were positively associated with discharge. History of microvascular complications, anticoagulant routine therapy, dyspnoea on admission, and higher aspartate aminotransferase, white cell count and C-reactive protein levels were associated with a reduced chance of discharge. Factors associated with death within 28 days mirrored those associated with discharge, and also included routine treatment by insulin and statin as deleterious factors. CONCLUSIONS/INTERPRETATION: In patients with diabetes hospitalised for COVID-19, we established prognostic factors for hospital discharge and death that could help clinicians in this pandemic period. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT04324736

Intérêt du dosage d'ARNm [acide ribonucléique messager] de thyroglobuline, dans le sang circulant, par RT-PCR [ transcription inverse suivie d'une réaction de polymérisation en chaîne] quantitative dans le suivi des cancers différenciés de la thyroïde

ANGERS-BU Médecine-Pharmacie (490072105) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Morality, cognition, education Beitraege zum 2. Konstanzer Werkstattgespraech ueber Moral und Umwelt, in Verbindung mit MOSAIC vom 17. bis 20. Juli 1984, Universitaet Konstanz

SIGLEUuStB Koeln(38)-850106102 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman

Assessment of ozone impacts on farming systems: A bio-economic modeling approach applied to the widely diverse French case

As a result of anthropogenic activities, ozone is produced in the surface atmosphere, causing direct damage to plants and reducing crop yields. By combining a biophysical crop model with an economic supply model we were able to predict and quantify this effect at a fine spatial resolution. We applied our approach to the very varied French case and showed that ozone has significant productivity and land-use effects. A comparison of moderate and high ozone scenarios for 2030 shows that wheat production may decrease by more than 30% and barley production may increase by more than 14% as surface ozone concentration increases. These variations are due to the direct effect of ozone on yields as well as to modifications in land use caused by a shift toward more ozone-resistant crops: our study predicts a 16% increase in the barley-growing area and an equal decrease in the wheat-growing area. Moreover, mean agricultural gross margin losses can go as high as 2.5% depending on the ozone scenario, and can reach 7% in some particularly affected regions. A rise in ozone concentration was also associated with a reduction of agricultural greenhouse gas emissions of about 2%, as a result of decreased use of nitrogen fertilizers. One noteworthy result was that major impacts, including changes in land use, do not necessarily occur in ozone high concentration zones, and may strongly depend on farm systems and their adaptation capability. Our study suggests that policy makers should view ozone pollution as a major potential threat to agricultural yields

Bio-economic assessment of ozone impacts on French farming systems

Bio-economic assessment of ozone impacts on French farming systems. 26. Task Force Meeting of the ICP Vegetatio

Type 1 Diabetes in People Hospitalized for COVID-19: New Insights From the CORONADO Study

International audienc

The association between macrovascular complications and intensive care admission, invasive mechanical ventilation, and mortality in people with diabetes hospitalized for coronavirus disease-2019 (COVID-19)

International audienceAbstract Background It is not clear whether pre-existing macrovascular complications (ischemic heart disease, stroke or peripheral artery disease) are associated with health outcomes in people with diabetes mellitus hospitalized for COVID-19. Methods We conducted cohort studies of adults with pre-existing diabetes hospitalized for COVID-19 infection in the UK, France, and Spain during the early phase of the pandemic (between March 2020—October 2020). Logistic regression models adjusted for demographic factors and other comorbidities were used to determine associations between previous macrovascular disease and relevant clinical outcomes: mortality, intensive care unit (ICU) admission and use of invasive mechanical ventilation (IMV) during the hospitalization. Output from individual logistic regression models for each cohort was combined in a meta-analysis. Results Complete data were available for 4,106 (60.4%) individuals. Of these, 1,652 (40.2%) had any prior macrovascular disease of whom 28.5% of patients died. Mortality was higher for people with compared to those without previous macrovascular disease (37.7% vs 22.4%). The combined crude odds ratio (OR) for previous macrovascular disease and mortality for all four cohorts was 2.12 (95% CI 1.83–2.45 with an I 2 of 60%, reduced after adjustments for age, sex, type of diabetes, hypertension, microvascular disease, ethnicity, and BMI to adjusted OR 1.53 [95% CI 1.29–1.81]) for the three cohorts. Further analysis revealed that ischemic heart disease and cerebrovascular disease were the main contributors of adverse outcomes. However, proportions of people admitted to ICU (adjOR 0.48 [95% CI 0.31–0.75], I 2 60%) and the use of IMV during hospitalization (adjOR 0.52 [95% CI 0.40–0.68], I 2 37%) were significantly lower for people with previous macrovascular disease. Conclusions This large multinational study of people with diabetes mellitus hospitalized for COVID-19 demonstrates that previous macrovascular disease is associated with higher mortality and lower proportions admitted to ICU and treated with IMV during hospitalization suggesting selective admission criteria. Our findings highlight the importance correctly assess the prognosis and intensive monitoring in this high-risk group of patients and emphasize the need to design specific public health programs aimed to prevent SARS-CoV-2 infection in this subgroup