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Observational Study
. 2021 Jul 13;76(8):e102-e109.
doi: 10.1093/gerona/glab124.

Cardiometabolic Therapy and Mortality in Very Old Patients With Diabetes Hospitalized due to COVID-19

Jose Manuel Ramos-Rincón  1 , Luis M Pérez-Belmonte  2 , Francisco Javier Carrasco-Sánchez  3 , Sergio Jansen-Chaparro  2 , Mercedes De-Sousa-Baena  3 , José Bueno-Fonseca  2 , Maria Pérez-Aguilar  3 , Coral Arévalo-Cañas  4 , Marta Bacete Cebrian  5 , Manuel Méndez-Bailón  6 , Isabel Fiteni Mera  7 , Andrés González García  8 , Francisco Navarro Romero  9 , Carlota Tuñón de Almeida  10 , Gemma Muñiz Nicolás  11 , Amara González Noya  12 , Almudena Hernández Milian  13 , Gema María García García  14 , José Nicolás Alcalá Pedrajas  15 , Virginia Herrero García  16 , Luis Corral-Gudino  17 , Pere Comas Casanova  18 , Héctor Meijide Míguez  19 , José Manuel Casas-Rojo  20 , Ricardo Gómez-Huelgas  2 ; SEMI-COVID-19 Network
Affiliations
Observational Study

Cardiometabolic Therapy and Mortality in Very Old Patients With Diabetes Hospitalized due to COVID-19

Jose Manuel Ramos-Rincón et al. J Gerontol A Biol Sci Med Sci. .

Abstract

Background: The effects of cardiometabolic drugs on the prognosis of diabetic patients with COVID-19, especially very old patients, are not well known. This work was aimed to analyze the association between preadmission cardiometabolic therapy (antidiabetic, antiaggregant, antihypertensive, and lipid-lowering drugs) and in-hospital mortality among patients ≥80 years with type 2 diabetes mellitus (T2DM) hospitalized for COVID-19.

Method: We conducted a nationwide, multicenter, observational study in patients ≥80 years with T2DM hospitalized for COVID-19 between March 1 and May 29, 2020. The primary outcome measure was in-hospital mortality. A multivariate logistic regression analysis was performed to assess the association between preadmission cardiometabolic therapy and in-hospital mortality.

Results: Of the 2 763 patients ≥80 years old hospitalized due to COVID-19, 790 (28.6%) had T2DM. Of these patients, 385 (48.7%) died during admission. On the multivariate analysis, the use of dipeptidyl peptidase-4 inhibitors (adjusted odds ratio [AOR] 0.502, 95% confidence interval [CI]: 0.309-0.815, p = .005) and angiotensin receptor blockers (AOR 0.454, 95% CI: 0.274-0.759, p = .003) were independent protectors against in-hospital mortality, whereas the use of acetylsalicylic acid was associated with higher in-hospital mortality (AOR 1.761, 95% CI: 1.092-2.842, p = .020). Other antidiabetic drugs, angiotensin-converting enzyme inhibitors, and statins showed neutral association with in-hospital mortality.

Conclusions: We found important differences between cardiometabolic drugs and in-hospital mortality in older patients with T2DM hospitalized for COVID-19. Preadmission treatment with dipeptidyl peptidase-4 inhibitors and angiotensin receptor blockers could reduce in-hospital mortality; other antidiabetic drugs, angiotensin-converting enzyme inhibitors, and statins seem to have a neutral effect; and acetylsalicylic acid could be associated with excess mortality.

Keywords: Age ≥ 80; Cardiometabolic therapy; Coronavirus disease-2019; Mortality; Type 2 diabetes.

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