Inflammation, Hyperglycemia, and Adverse Outcomes in Individuals With Diabetes Mellitus Hospitalized for COVID-19 Article Swipe
Alexi Vasbinder
,
Élizabeth Anderson
,
Husam Shadid
,
Hanna Berlin
,
Michael Pan
,
Tariq U. Azam
,
Ibrahim Khaleel
,
Kishan Padalia
,
Chelsea Meloche
,
Patrick O’Hayer
,
Erinleigh Michaud
,
Tonimarie Catalan
,
Rafey Feroze
,
Pennelope Blakely
,
Christopher Launius
,
Yiyuan Huang
,
Lili Zhao
,
Lynn Ang
,
Monica Mikhael
,
Kara Mizokami‐Stout
,
Subramaniam Pennathur
,
Matthias Kretzler
,
Sven H. Loosen
,
Athanasios Chalkias
,
Frank Tacke
,
Evangelos J. Giamarellos‐Bourboulis
,
Jochen Reiser
,
Jesper Eugen‐Olsen
,
Eva L. Feldman
,
Rodica Pop‐Busui
,
Salim S. Hayek
·
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.2337/dc21-2102
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.2337/dc21-2102
OBJECTIVE Diabetes mellitus (DM) is a major risk factor for severe coronavirus disease 2019 (COVID-19) for reasons that are unclear. RESEARCH DESIGN AND METHODS We leveraged the International Study of Inflammation in COVID-19 (ISIC), a multicenter observational study of 2,044 patients hospitalized with COVID-19, to characterize the impact of DM on in-hospital outcomes and assess the contribution of inflammation and hyperglycemia to the risk attributed to DM. We measured biomarkers of inflammation collected at hospital admission and collected glucose levels and insulin data throughout hospitalization. The primary outcome was the composite of in-hospital death, need for mechanical ventilation, and need for renal replacement therapy. RESULTS Among participants (mean age 60 years, 58.2% males), those with DM (n = 686, 33.5%) had a significantly higher cumulative incidence of the primary outcome (37.8% vs. 28.6%) and higher levels of inflammatory biomarkers than those without DM. Among biomarkers, DM was only associated with higher soluble urokinase plasminogen activator receptor (suPAR) levels in multivariable analysis. Adjusting for suPAR levels abrogated the association between DM and the primary outcome (adjusted odds ratio 1.23 [95% CI 0.78, 1.37]). In mediation analysis, we estimated the proportion of the effect of DM on the primary outcome mediated by suPAR at 84.2%. Hyperglycemia and higher insulin doses were independent predictors of the primary outcome, with effect sizes unaffected by adjusting for suPAR levels. CONCLUSIONS Our findings suggest that the association between DM and outcomes in COVID-19 is largely mediated by hyperinflammation as assessed by suPAR levels, while the impact of hyperglycemia is independent of inflammation.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.2337/dc21-2102
- https://diabetesjournals.org/care/article-pdf/45/3/692/670807/dc212102.pdf
- OA Status
- bronze
- Cited By
- 71
- References
- 41
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4206033420
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4206033420Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.2337/dc21-2102Digital Object Identifier
- Title
-
Inflammation, Hyperglycemia, and Adverse Outcomes in Individuals With Diabetes Mellitus Hospitalized for COVID-19Work title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2022Year of publication
- Publication date
-
2022-01-19Full publication date if available
- Authors
-
Alexi Vasbinder, Élizabeth Anderson, Husam Shadid, Hanna Berlin, Michael Pan, Tariq U. Azam, Ibrahim Khaleel, Kishan Padalia, Chelsea Meloche, Patrick O’Hayer, Erinleigh Michaud, Tonimarie Catalan, Rafey Feroze, Pennelope Blakely, Christopher Launius, Yiyuan Huang, Lili Zhao, Lynn Ang, Monica Mikhael, Kara Mizokami‐Stout, Subramaniam Pennathur, Matthias Kretzler, Sven H. Loosen, Athanasios Chalkias, Frank Tacke, Evangelos J. Giamarellos‐Bourboulis, Jochen Reiser, Jesper Eugen‐Olsen, Eva L. Feldman, Rodica Pop‐Busui, Salim S. HayekList of authors in order
- Landing page
-
https://doi.org/10.2337/dc21-2102Publisher landing page
- PDF URL
-
https://diabetesjournals.org/care/article-pdf/45/3/692/670807/dc212102.pdfDirect link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
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bronzeOpen access status per OpenAlex
- OA URL
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https://diabetesjournals.org/care/article-pdf/45/3/692/670807/dc212102.pdfDirect OA link when available
- Concepts
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SuPAR, Medicine, Diabetes mellitus, Internal medicine, Odds ratio, Inflammation, Urokinase receptor, Plasminogen activator, EndocrinologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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71Total citation count in OpenAlex
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2025: 15, 2024: 18, 2023: 20, 2022: 18Per-year citation counts (last 5 years)
- References (count)
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41Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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| countries_distinct_count | 4 |
| institutions_distinct_count | 31 |
| corresponding_institution_ids | https://openalex.org/I27837315 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.7200000286102295 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.98186962 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | True |