12 May 2020
CORONADO publishes its first results in Diabetologia
The first results of the CORONADO study are published today in the scientific journal Diabetologia.
Presse release :
COVID-19 and diabetes: French diabetologists publish the 1st global study on the profile of hospitalized diabetics in order to improve their management
Nantes, May 12, 2020 – In record time, French diabetologists have initiated a network of 68 centres as part of the CORONADO study. Objective: to describe the characteristics of diabetic patients hospitalized for COVID-19 in order to improve their management. This study, the first results of which are published today in the scientific journal Diabetologia, is promoted by the Nantes University Hospital and coordinated by Prof. Bertrand CARIOU, a diabetologist in the Departement of Endocrinology, Diabetology and Nutrition of l’institut du thorax.
Why CORONADO ?
Since the beginning of the COVID-19 pandemic, more than 4 million diabetics in France have shared their concerns with their doctors: “Am I at greater risk with type 1 diabetes¹? What complications do I risk having as a type 2² diabetic? Should I continue my treatment? Can I continue to work? ». In order to answer these legitimate questions and to clarify the data specific to the diabetic disease, all those involved in French diabetology – patients, healthcare professionals, clinical research associates and researchers – have joined forces and initiated the CORONADO (CORONAvirus SARS-Cov2 & Diabetes Outcomes) study, the first worldwide study looking at the characteristics of diabetics hospitalized for COVID-19.
This observational, essentially retrospective study analyzed data collected from patients’ medical records. It is promoted by the Nantes University Hospital and coordinated by a National Scientific Council, led by Prof. Bertrand CARIOU and Samy HADJADJ, diabetologists in the Department of Endocrinology, Diabetology and Nutrition of l’institut du thorax. CORONADO is an initiative supported by the Société Francophone du Diabète (SFD), the Fédération Française des Diabétiques (FFD), a patient association, and the Fondation Francophone pour la Recherche sur le Diabète (FFRD).
One of the first successes of this study is the setting up in only 2 weeks of an incredible network of 68 public and private diabetes centres in metropolitan France and overseas, thanks to the support of learned societies and patient associations. Thanks to the voluntary participation of all the centres and the exemplary mobilization of hospital clinical research agents, nearly 3,000 diabetic patients were included in the end in just 20 days, compared with the initial target of 300 patients.
The CORONADO study analyzed the medical records of diabetic subjects admitted to hospital for COVID-19 between March 10 and April 10, 2020. The first results, published today in the European journal Diabetologia, cover subjects treated between March 10 and 31, i.e. 1317 analyzable subjects. They describe :
- the typical patient profile: The average age of hospitalized diabetics is 70. 35% are women and 65% are men. The majority of hospitalized subjects have type 2 diabetes (89%) and a minority have type 1 diabetes (3%). In some cases, diabetes was discovered at the time of hospitalization (3%).
- their complications and short-term risks: microvascular complications (eye, kidney and nerves) are present in 47% of the subjects in the study. Macrovascular complications (arteries of the heart, brain, legs) are found in 41% of the patients analyzed. In the 7 days following admission to hospital, the risk for a diabetic patient to be intubated (to be artificially ventilated in intensive care) is 20.3%, and the risk of dying is 10.6%, while 18% of them return home.
Since the data are collected on a large number of patients, they make it possible to establish the following observations and recommendations:
• The risk factors for severe forms of COVID-19 are identical to those found in the general population: age and corpulence (excess weight is a risk factor for severe forms of COVID-19).
• Subjects with diabetic complications are at higher risk of death with COVID-19.
• Insulin, like other treatments for diabetes, is not a risk factor for the severe form of COVID-19. Treatment should be continued.
CORONADO goes further
This scientific publication in a reference journal is the first step in a larger effort to collect and analyze data on nearly 3,000 patients participating in the study, for a planned follow-up until the 28th day after their admission to hospital, with further analyses expected in early June.
At the same time, this study could be extended to the analysis of other important issues such as the impact of COVID-19 on care consumption and diabetes complications at a distance from hospitalization, as well as a comparison of data in diabetic patients with those of non-diabetic patients. Finally, the French CORONADO network could be opened up to several French-speaking countries.
¹Type 1 diabetes: An autoimmune disease occurring in young people and requiring lifetime administration of insulin. It accounts for 10% of diabetes cases, i.e. 400,000 patients in France.
²Type 2 diabetes: This diabetes increases with age, overweight, obesity, sedentary lifestyle. It is treated by hygieno-dietary measures, medication and frequently insulin. It accounts for 85% of diabetes cases.