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COVID-19 Severity is Tripled in the Diabetes Community: A Prospective Analysis of the Pandemic’s Impact in Type 1 and Type 2 Diabetes

Authors :
Daniel J. Moore
T. Jordan Smith
Allison B. McCoy
James M. Luther
Sarah S. Jaser
Justin M. Gregory
Schafer Boeder
Sara H Duffus
Erin R. Giovannetti
Lauren M. LeStourgeon
James C. Slaughter
Jeremy Pettus
Source :
Diabetes care, vol 44, iss 2, Diabetes Care
Publication Year :
2020
Publisher :
American Diabetes Association, 2020.

Abstract

OBJECTIVE To quantify and contextualize the risk for coronavirus disease 2019 (COVID-19)–related hospitalization and illness severity in type 1 diabetes. RESEARCH DESIGN AND METHODS We conducted a prospective cohort study to identify case subjects with COVID-19 across a regional health care network of 137 service locations. Using an electronic health record query, chart review, and patient contact, we identified clinical factors influencing illness severity. RESULTS We identified COVID-19 in 6,138, 40, and 273 patients without diabetes and with type 1 and type 2 diabetes, respectively. Compared with not having diabetes, people with type 1 diabetes had adjusted odds ratios of 3.90 (95% CI 1.75–8.69) for hospitalization and 3.35 (95% CI 1.53–7.33) for greater illness severity, which was similar to risk in type 2 diabetes. Among patients with type 1 diabetes, glycosylated hemoglobin (HbA1c), hypertension, race, recent diabetic ketoacidosis, health insurance status, and less diabetes technology use were significantly associated with illness severity. CONCLUSIONS Diabetes status, both type 1 and type 2, independently increases the adverse impacts of COVID-19. Potentially modifiable factors (e.g., HbA1c) had significant but modest impact compared with comparatively static factors (e.g., race and insurance) in type 1 diabetes, indicating an urgent and continued need to mitigate severe acute respiratory syndrome coronavirus 2 infection risk in this community.

Details

Database :
OpenAIRE
Journal :
Diabetes care, vol 44, iss 2, Diabetes Care
Accession number :
edsair.doi.dedup.....4be93bdd081bcdbfbd30e3968951ffc3
Full Text :
https://doi.org/10.2337/figshare.13235066