Abstract | OBJECTIVE: RESEARCH DESIGN AND METHODS: 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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Authors | Alexi Vasbinder, Elizabeth 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, ISIC Study Group |
Journal | Diabetes care
(Diabetes Care)
Vol. 45
Issue 3
Pg. 692-700
(03 01 2022)
ISSN: 1935-5548 [Electronic] United States |
PMID | 35045184
(Publication Type: Journal Article, Multicenter Study, Observational Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Copyright | © 2022 by the American Diabetes Association. |
Chemical References |
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Topics |
- Biomarkers
- COVID-19
- Diabetes Mellitus
(epidemiology)
- Female
- Hospital Mortality
- Hospitalization
- Humans
- Hyperglycemia
- Inflammation
- Male
- Middle Aged
- SARS-CoV-2
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