Viruses (Jun 2022)

Biomarkers Predictive for In-Hospital Mortality in Patients with Diabetes Mellitus and Prediabetes Hospitalized for COVID-19 in Austria: An Analysis of COVID-19 in Diabetes Registry

  • Faisal Aziz,
  • Hannah Stöcher,
  • Alexander Bräuer,
  • Christian Ciardi,
  • Martin Clodi,
  • Peter Fasching,
  • Mario Karolyi,
  • Alexandra Kautzky-Willer,
  • Carmen Klammer,
  • Oliver Malle,
  • Felix Aberer,
  • Erich Pawelka,
  • Slobodan Peric,
  • Claudia Ress,
  • Caren Sourij,
  • Lars Stechemesser,
  • Harald Stingl,
  • Thomas Stulnig,
  • Norbert Tripolt,
  • Michael Wagner,
  • Peter Wolf,
  • Andreas Zitterl,
  • Othmar Moser,
  • Christian Schelkshorn,
  • Susanne Kaser,
  • Harald Sourij,
  • for the COVID-19 in Diabetes in Austria

DOI
https://doi.org/10.3390/v14061285
Journal volume & issue
Vol. 14, no. 6
p. 1285

Abstract

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Background: This study assessed the predictive performance of inflammatory, hepatic, coagulation, and cardiac biomarkers in patients with prediabetes and diabetes mellitus hospitalized for COVID-19 in Austria. Methods: This was an analysis of a multicenter cohort study of 747 patients with diabetes mellitus or prediabetes hospitalized for COVID-19 in 11 hospitals in Austria. The primary outcome of this study was in-hospital mortality. The predictor variables included demographic characteristics, clinical parameters, comorbidities, use of medication, disease severity, and laboratory measurements of biomarkers. The association between biomarkers and in-hospital mortality was assessed using simple and multiple logistic regression analyses. The predictive performance of biomarkers was assessed using discrimination and calibration. Results: In our analysis, 70.8% had type 2 diabetes mellitus, 5.8% had type 1 diabetes mellitus, 14.9% had prediabetes, and 8.6% had other types of diabetes mellitus. The mean age was 70.3 ± 13.3 years, and 69.3% of patients were men. A total of 19.0% of patients died in the hospital. In multiple logistic regression analysis, LDH, CRP, IL-6, PCT, AST-ALT ratio, NT-proBNP, and Troponin T were significantly associated with in-hospital mortality. The discrimination of NT-proBNP was 74%, and that of Troponin T was 81%. The calibration of NT-proBNP was adequate (p = 0.302), while it was inadequate for Troponin T (p = 0.010). Conclusion: Troponin T showed excellent predictive performance, while NT-proBNP showed good predictive performance for assessing in-hospital mortality in patients with diabetes mellitus hospitalized with COVID-19. Therefore, these cardiac biomarkers may be used for prognostication of COVID-19 patients.

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