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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

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posted on 02.12.2020, 23:01 by Justin M. Gregory, James C. Slaughter, Sara H. Duffus, T. Jordan Smith, Lauren M. LeStourgeon, Sarah S. Jaser, Allison B. McCoy, James M. Luther, Erin R. Giovannetti, Schafer Boeder, Jeremy H. Pettus, Daniel J. Moore
Objective: To quantify and contextualize the risk for COVID-19 related hospitalization and illness severity in type 1 diabetes.

Research Design and Methods: We conducted a prospective cohort study to identify COVID-19 cases across a regional healthcare 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 (ORs) 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 type 1 diabetes patients, glycosylated hemoglobin (HbA1c), hypertension, race, recent diabetic ketoacidosis (DKA), 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 to comparatively static factors (e.g. race, insurance) in type 1 diabetes indicating an urgent and continued need to mitigate SARS-CoV-2 infection risk in this community.

Funding

Research supported in this publication was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under award number K23DK123392 (J.M.G.) and T32DK007061 (S.H.D.). J.M.G was supported by a JDRF Career Development Award (5-ECR-2020-950-A-N). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the JDRF.

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