Diabetes mellitus as a risk factor for poor early outcomes in patients hospitalized with COVID-19
Diabetes mellitus and obesity are highly prevalent among hospitalized patients with COVID-19, but little is known about their contributions to early COVID-19 outcomes. We tested the hypothesis that diabetes is a risk factor for poor early outcomes, after adjustment for obesity, among a cohort of patients hospitalized with COVID-19.
RESEARCH DESIGN AND METHODS We used data from the Massachusetts General Hospital (MGH) COVID-19 Data Registry of patients hospitalized with COVID-19 between March 11, 2020 and April 30, 2020. Primary outcomes were admission to the intensive care unit (ICU), need for mechanical ventilation, and death within 14 days of presentation to care. Logistic regression models were adjusted for demographic characteristics, obesity, and relevant comorbidities.
Among 450 patients, 178 (39.6%) had diabetes, mostly type 2 diabetes. A higher proportion of patients with diabetes were admitted to the ICU (42.1% vs. 29.8%, p=0.007), required mechanical ventilation (37.1% vs. 23.2%, p=0.001), and died (15.9% vs. 7.9%, p=0.009), compared with patients without diabetes. In multivariable logistic regression models, diabetes was associated with greater odds of ICU admission (OR 1.59 [95% CI 1.01-2.52]), mechanical ventilation (1.97 [1.21-3.20]), and death (2.02 [1.01-4.03]) at 14-days. Obesity was associated with higher odds of ICU admission (2.16 [1.20-3.88]) and mechanical ventilation (2.13 [1.14-4.00]) but not with death.
Among hospitalized patients with COVID-19, diabetes was associated with poor early outcomes, after adjusting for obesity. These findings can help inform patient-centered care decision making for people with diabetes at risk of COVID-19.