CORONADO: The first large-scale study dedicated to diabetes and COVID-19
CORONADO is a nationwide multicentric study conducted in 68 centres in France and sponsored by Nantes University Hospital (PI: Prof. Bertrand Cariou, director of l’institut du thorax). For the current analysis, 1,317 inpatients with diabetes and COVID-19 were recruited from March 10 to 31, 2020. The primary outcome combined tracheal intubation for mechanical ventilation and/or death within 7 days of admission. The characteristics of the participants are detailed in the graphical abstract.
In people with diabetes hospitalised for COVID-19, on day 7, the primary outcome occurred in 29.0% and death in 10.6%, while discharge was possible in 18.0%. Body Mass Index (BMI) was independently associated with the severity of COVID-19, in contrast to long-term glycaemic control (assessed by HbA1c measurement) or routine therapies (including RAAS blockers and DPP-4 inhibitors). In addition, age, microvascular and macrovascular diabetic complications, treated obstructive sleep apnoea, as well as dyspnoea were independently associated with the risk of early death in people with diabetes hospitalised for COVID-19.
CORONADO gives important insights for the clinicians to manage people with diabetes. Notably, a special attention should be paid to elderly people with long-standing diabetes and advanced diabetic complications: they are at increased risk of fatal COVID-19 and therefore require strict application of specific management to avoid contamination with SARS-CoV-2. Increased BMI (starting in the overweight ranges) was an independent prognosis factor of COVID-19 severity and the link between obesity and COVID-19 deserves further investigations.