Diabetes mellitus is highly prevalent in the United States and increases the risk of severe illness in patients with COVID-19. We compared outcomes in hospitalized COVID-19 patients with and without diabetes using the National Inpatient Sample (2020-2022), adjusting for confounders via multivariable logistic regression. Among 5,934,565 hospitalizations for COVID-19, 2,155,978 (36.3%) had concomitant diabetes. The diabetes group had higher unadjusted in-hospital mortality (13.5% vs. 10.1%), but was not independently associated with mortality after adjustment (aOR 0.98; 95% CI 0.97-1.00). However, diabetes was independently associated with higher incidence of acute respiratory failure (46.1% vs 42.3%, aOR 1.29; 95% CI: 1.27-1.30), greater need for invasive mechanical ventilation (aOR 1.22; 95% CI 1.20-1.24) and non-invasive ventilation (aOR 1.27; 95% CI 1.25-1.29). These patients also had higher rates of ARDS, acute kidney injury, renal replacement therapy, sepsis, septic shock, and vasopressor use, along with longer length of hospital stay and higher total charges of hospitalization. Mortality among COVID-19 patients with diabetes declined through 2020-2022 (15.8% to 8.4%). Diabetes was not independently associated with in-hospital mortality but was associated with greater respiratory, renal, hemodynamic complications and hospital resource utilization. Early recognition and management of diabetes is warranted in patients with COVID-19.

Background: Diabetes mellitus (DM) is highly prevalent in the United States and increases the risk of severe illness in patients with COVID-19. We compared outcomes among adult COVID-19 hospitalizations with and without DM. Methods: We compared the National Inpatient Sample (2020–2022), using multivariate regression to adjust for potential confounders. Results: Among 5,934,565 hospitalizations for COVID-19, 2,155,978 (36.3%) had concomitant DM. The DM group had higher unadjusted in-hospital mortality (13.5% vs. 10.1%) and was associated with higher mortality after adjustment (aOR 1.17; 95% CI, 1.15–1.19; p < 0.001). DM was also independently associated with higher odds of acute respiratory failure (46.1% vs. 42.3%; aOR 1.12; 95% CI, 1.11–1.13; p < 0.001), greater use of invasive mechanical ventilation (aOR 1.35; 95% CI, 1.33–1.37; p < 0.001) and non-invasive ventilation (NIV; aOR 1.42; 95% CI, 1.40–1.45; p < 0.001). COVID-19 hospitalizations with DM also had higher rates of acute respiratory distress syndrome, acute kidney injury, renal replacement therapy, sepsis, septic shock, and vasopressor use, along with longer length of hospital stay and higher total hospitalization charges. In-hospital mortality among COVID-19 hospitalizations with DM was lower in 2022 than in 2020 and 2021. Conclusions: DM was associated with higher in-hospital mortality and greater respiratory, renal, and hemodynamic complications and hospital resource utilization.

Background: COVID-19 infection has been a major cause of hospitalization and mortality in the United States. Patients with liver cirrhosis may be especially vulnerable to severe outcomes of COVID-19 infection because of immune dysfunction, systemic inflammation, portal hypertension, and reduced physiologic reserve. These factors can increase the risk of severe infection, multiorgan complications, and poor inpatient outcomes. Using the 2020-2022 United States National Inpatient Sample, this study evaluates the effect of cirrhosis among adults hospitalized with COVID-19. Methods: We performed a retrospective cohort study using the National Inpatient Sample (NIS) database. Adult hospitalizations with COVID-19 from 2020 to 2022 were included and stratified according to the presence or absence of cirrhosis. Using multivariable logistic regression analyses, we evaluated in-hospital mortality as the primary outcome. Secondary outcomes included need for mechanical ventilation, septic shock, ARDS, ECMO utilization, acute kidney injury, renal replacement therapy, length of stay, and hospital charges. Results: A total of 5,934,565 hospitalized COVID-19 patients were included, of which 115,170 had concomitant cirrhosis. COVID-19 patients with cirrhosis had a higher in-hospital mortality than those without cirrhosis (16.8% vs. 11.3%; aOR 1.28; 95% CI 1.22-1.32). Patients with liver cirrhosis were also associated with higher odds of invasive mechanical ventilation, vasopressor use and septic shock. Conclusions: Cirrhosis was independently associated with increased in-hospital mortality and complications including need for invasive mechanical ventilation and septic shock in adults hospitalized with COVID-19. Although mortality associated with these patients have declined over time, they represent a high risk group that requires close monitoring.

Clinical studies have shown that patients who had sepsis with COVID-19 infection had worse clinical outcomes, however, there is a paucity of data on the nationwide impact of COVID-19 infection in patients with sepsis. Hence, we conducted a retrospective cohort study using the National Inpatient Sample (NIS) database from 2020 through 2022 to determine the impact of COVID-19 infection on the outcomes of patients with sepsis. Adult sepsis hospitalizations were identified using ICD-10-CM codes and stratified by concurrent COVID-19 infection status. Survey weighted multivariate regression analysis was performed. Patients with sepsis with concurrent COVID-19 infection had worse outcomes with higher mortality rate (15.6% vs 5.4%; aOR 3.71; 95% CI 3.62-3.80), higher need for invasive ventilation (13.1% vs 6.5%) and NIV (non-invasive ventilation) (10.2% vs 4.9%), higher incidence of acute kidney injury (37.6% vs 36.7%), acute respiratory failure (57.5% vs 20.3%), acute liver failure (1.0% vs 1.2%), disseminated intravascular coagulation (DIC) (0.4% vs 0.3%), cardiac arrest (3.1% vs 1.5%), acute respiratory distress syndrome (ARDS) (7.9% vs 0.4%), higher need for renal replacement therapy (4.9% vs 4.5%), tracheostomy (1.6% vs 0.6%), extra corporeal membrane oxygenation (ECMO) (0.2% vs 0.04%), longer length of hospital stay (10.3 days vs 7.6 days), higher total charges ($127,632 vs $93,735 respectively). The results demonstrate that the COVID-19 infection was independently associated with worse clinical outcomes among hospitalized with sepsis. These results underscore the need for early recognition, aggressive treatment, and targeted therapy in this high-risk clinical group.

Background: COVID-19 infection has been a major cause of hospitalization and mortality in the United States. Patients with liver cirrhosis may be especially vulnerable to severe outcomes of COVID-19 infection because of immune dysfunction, systemic inflammation, portal hypertension, and reduced physiological reserve. These factors can increase the risk of severe infection, multiorgan complications, and poor inpatient outcomes. Using the 2020–2022 United States National Inpatient Sample, this study evaluates the effect of cirrhosis among adults hospitalized with COVID-19. Methods: We performed a retrospective cohort study using the National Inpatient Sample (NIS) database. Adult hospitalizations with COVID-19 from 2020 to 2022 were included and stratified according to the presence or absence of cirrhosis. Using multivariable logistic regression analyses, we evaluated in-hospital mortality as the primary outcome. Secondary outcomes included the need for mechanical ventilation, septic shock, ARDS, ECMO utilization, acute kidney injury, renal replacement therapy, length of stay, and hospital charges. Results: A total of 5,934,565 hospitalized COVID-19 patients were included, of which 115,170 had concomitant cirrhosis. COVID-19 patients with cirrhosis had a higher in-hospital mortality than those without cirrhosis (16.8% vs. 11.3%; aOR 1.28; 95% CI 1.22–1.32). Patients with liver cirrhosis were also associated with higher odds of invasive mechanical ventilation, vasopressor use, and septic shock. Conclusions: Cirrhosis was independently associated with increased in-hospital mortality and complications including the need for invasive mechanical ventilation and septic shock in adults hospitalized with COVID-19. Although mortality associated with these patients has declined over time, they represent a high-risk group that requires close monitoring.

Background/Objectives: Clinical studies have shown that patients who had sepsis with COVID-19 infection had worse clinical outcomes; however, there is a paucity of data on the association between concurrent COVID-19 infection and outcomes among patients with sepsis. Hence, we conducted a retrospective cohort study using the National Inpatient Sample (NIS) database from 2020 through 2022 to evaluate the association between concurrent COVID-19 infection and outcomes among patients with sepsis. Methods: Adult hospitalizations with sepsis were identified using ICD-10-CM codes; hospitalizations with septic shock were excluded, and the remaining cohort was stratified by concurrent COVID-19 infection status. Survey-weighted multivariate regression analysis was performed. Results: Patients with sepsis with concurrent COVID-19 infection had worse outcomes with higher mortality rate (15.6% vs. 5.4%; aOR 3.70; 95% CI 3.62–3.79), higher need for invasive ventilation (13.1% vs. 6.5%) and NIV (non-invasive ventilation) (10.2% vs. 4.9%), higher incidence of acute kidney injury (37.6% vs. 36.7%), acute respiratory failure (57.5% vs. 20.3%), disseminated intravascular coagulation (DIC) (0.4% vs. 0.3%), cardiac arrest (3.1% vs. 1.5%), acute respiratory distress syndrome (ARDS) (7.9% vs. 0.4%), higher need for renal replacement therapy (4.9% vs. 4.5%), tracheostomy (1.6% vs. 0.6%), extracorporeal membrane oxygenation (ECMO) (0.2% vs. 0.04%), longer length of hospital stay (10.3 days vs. 7.6 days), and higher total charges ($127,632 vs. $93,735, respectively). Conclusions: The results demonstrate that COVID-19 infection was independently associated with worse clinical outcomes among those hospitalized with sepsis. These results underscore the need for early recognition, aggressive treatment, and targeted therapy in this high-risk clinical group.