{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:38:22Z","timestamp":1762508302819,"version":"3.41.2"},"reference-count":32,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2020,11,18]],"date-time":"2020-11-18T00:00:00Z","timestamp":1605657600000},"content-version":"unspecified","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Shanghai Top-Priority Clinical Key Disciplines Construction Project","award":["2017ZZ02013"],"award-info":[{"award-number":["2017ZZ02013"]}]},{"name":"Prevention and Treatment of Infection in Novel Coronavirus Pneumonia Patients from the Science and Technology Committee of Shanghai Municipality","award":["20411950402"],"award-info":[{"award-number":["20411950402"]}]},{"name":"Shanghai Municipal Key Clinical Specialty","award":["shslczdzk02201"],"award-info":[{"award-number":["shslczdzk02201"]}]},{"name":"the Sub-specialist project of Qingpu Branch of Zhongshan Hospital, Fudan University","award":["YZK 2019-04"],"award-info":[{"award-number":["YZK 2019-04"]}]},{"name":"the National Natural Science Foundation of China (NSFC) for Novel Coronavirus Pneumonia","award":["82041003"],"award-info":[{"award-number":["82041003"]}]},{"name":"the Shanghai key discipline of medicine","award":["ZK2019B07 SZ2019-1"],"award-info":[{"award-number":["ZK2019B07 SZ2019-1"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Diab Res Care"],"accepted":{"date-parts":[[2020,11,2]]},"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>To investigate the risk factors for the death in patients with COVID-19 with type 2 diabetes mellitus (T2DM).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Research design and methods<\/jats:title>\n                  <jats:p>We retrospectively enrolled inpatients with COVID-19 from Wuhan Jinyintan Hospital (Wuhan, China) between December 25, 2019, and March 3, 2020. The epidemiological and clinical data were compared between non-T2DM and T2DM or between survivors and non-survivors. Univariable and multivariable Cox regression analyses were used to explore the effect of T2DM and complications on in-hospital death.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 1105 inpatients with COVID-19, 967 subjects with without T2DM (n=522 male, 54.0%) and 138 subjects with pre-existing T2DM (n=82 male, 59.4%) were included for baseline characteristics analyses. The complications were also markedly increased in patients with pre-existing T2DM, including acute respiratory distress syndrome (ARDS) (48.6% vs 32.3%, p&lt;0.001), acute cardiac injury (ACI) (36.2% vs 16.7%, p&lt;0.001), acute kidney injury (AKI) (24.8% vs 9.5%, p&lt;0.001), coagulopathy (24.8% vs 11.1%, p&lt;0.001), and hypoproteinemia (21.2% vs 9.4%, p&lt;0.001). The in-hospital mortality was significantly higher in patients with pre-existing T2DM compared with those without T2DM (35.3% vs 17.4%, p&lt;0.001). Moreover, in hospitalized patients with COVID-19 with T2DM, ARDS and coagulopathy were the main causes of mortality, with an HR of 7.96 (95% CI 2.25 to 28.24, p=0.001) for ARDS and an HR of 2.37 (95% CI 1.08 to 5.21, p=0.032) for coagulopathy. This was different from inpatients with COVID-19 without T2DM, in whom ARDS and cardiac injury were the main causes of mortality, with an HR of 12.18 (95% CI 5.74 to 25.89, p&lt;0.001) for ARDS and an HR of 4.42 (95% CI 2.73 to 7.15, p&lt;0.001) for cardiac injury.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Coagulopathy was a major extrapulmonary risk factor for death in inpatients with COVID-19 with T2DM rather than ACI and AKI, which were well associated with mortality in inpatients with COVID-19 without T2DM.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjdrc-2020-001851","type":"journal-article","created":{"date-parts":[[2020,11,19]],"date-time":"2020-11-19T21:57:47Z","timestamp":1605823067000},"page":"e001851","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Coagulopathy is a major extrapulmonary risk factor for mortality in hospitalized patients with COVID-19 with type 2 diabetes"],"prefix":"10.1136","volume":"8","author":[{"given":"Xiaoyan","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaomin","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China"},{"name":"Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Qingpu Branch, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Wei","sequence":"additional","affiliation":[{"name":"Tuberculosis and Respiratory Department, Wuhan Jinyintan Hospital, Wuhan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Fengxian Guhua Hospital, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yen-cheng","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongni","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7106-2159","authenticated-orcid":false,"given":"Yuye","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunling","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Qingpu Branch, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoying","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9826-4383","authenticated-orcid":false,"given":"Yuanlin","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China"},{"name":"Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Qingpu Branch, Shanghai, China"},{"name":"Shanghai Respiratory Research Institute, Shanghai, China"},{"name":"National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,11,19]]},"reference":[{"key":"2025073111413847000_8.2.e001851.1","unstructured":"World Health Organization . 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