Preadmission predictors of severe COVID-19 in patients with diabetes mellitus

doi:10.1016/j.jdiacomp.2021.107967

Observational Study

. 2021 Aug;35(8):107967.

doi: 10.1016/j.jdiacomp.2021.107967. Epub 2021 May 28.

Preadmission predictors of severe COVID-19 in patients with diabetes mellitus

Affiliations

¹ Weill Cornell Medicine, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Comprehensive Weight Control Center, New York, NY 10065, USA. Electronic address: aps2004@med.cornell.edu.
² Weill Cornell Medicine, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Comprehensive Weight Control Center, New York, NY 10065, USA. Electronic address: bgt9001@med.cornell.edu.
³ Weill Cornell Medical College, New York, NY 10065, USA. Electronic address: til4007@med.cornell.edu.
⁴ Western University of Health Sciences, Lebanon, OR 97355, USA. Electronic address: ian.steller@westernu.edu.
⁵ Weill Cornell Medical College, New York, NY 10065, USA. Electronic address: sat2032@med.cornell.edu.
⁶ Weill Cornell Medicine, Department of Population Health Sciences, Division of Biostatistics, New York, NY 10065, USA.
⁷ Weill Cornell Medicine, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, New York, NY 10065, USA. Electronic address: fam9025@med.cornell.edu.
⁸ Weill Cornell Medicine, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, New York, NY 10065, USA. Electronic address: jas9067@med.cornell.edu.
⁹ Weill Cornell Medicine and New-York Presbyterian Hospital Queens, Department of Medicine, Division of Endocrinology, New York, NY 10065, USA. Electronic address: dll9004@nyp.org.
¹⁰ Weill Cornell Medicine, Department of Medicine, New York, NY 10065, USA. Electronic address: mms9024@med.cornell.edu.
¹¹ Weill Cornell Medicine, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Comprehensive Weight Control Center, New York, NY 10065, USA. Electronic address: ljaronne@med.cornell.edu.
¹² Weill Cornell Medicine, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, New York, NY 10065, USA. Electronic address: lca4001@med.cornell.edu.

PMID: 34099384
PMCID: PMC8162023
DOI: 10.1016/j.jdiacomp.2021.107967

Observational Study

Preadmission predictors of severe COVID-19 in patients with diabetes mellitus

Alpana P Shukla et al. J Diabetes Complications. 2021 Aug.

. 2021 Aug;35(8):107967.

doi: 10.1016/j.jdiacomp.2021.107967. Epub 2021 May 28.

Authors

Affiliations

¹ Weill Cornell Medicine, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Comprehensive Weight Control Center, New York, NY 10065, USA. Electronic address: aps2004@med.cornell.edu.
² Weill Cornell Medicine, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Comprehensive Weight Control Center, New York, NY 10065, USA. Electronic address: bgt9001@med.cornell.edu.
³ Weill Cornell Medical College, New York, NY 10065, USA. Electronic address: til4007@med.cornell.edu.
⁴ Western University of Health Sciences, Lebanon, OR 97355, USA. Electronic address: ian.steller@westernu.edu.
⁵ Weill Cornell Medical College, New York, NY 10065, USA. Electronic address: sat2032@med.cornell.edu.
⁶ Weill Cornell Medicine, Department of Population Health Sciences, Division of Biostatistics, New York, NY 10065, USA.
⁷ Weill Cornell Medicine, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, New York, NY 10065, USA. Electronic address: fam9025@med.cornell.edu.
⁸ Weill Cornell Medicine, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, New York, NY 10065, USA. Electronic address: jas9067@med.cornell.edu.
⁹ Weill Cornell Medicine and New-York Presbyterian Hospital Queens, Department of Medicine, Division of Endocrinology, New York, NY 10065, USA. Electronic address: dll9004@nyp.org.
¹⁰ Weill Cornell Medicine, Department of Medicine, New York, NY 10065, USA. Electronic address: mms9024@med.cornell.edu.
¹¹ Weill Cornell Medicine, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Comprehensive Weight Control Center, New York, NY 10065, USA. Electronic address: ljaronne@med.cornell.edu.
¹² Weill Cornell Medicine, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, New York, NY 10065, USA. Electronic address: lca4001@med.cornell.edu.

PMID: 34099384
PMCID: PMC8162023
DOI: 10.1016/j.jdiacomp.2021.107967

Abstract

Objective: To explore predictors of severe COVID-19 disease in patients with diabetes hospitalized for COVID-19.

Methods: This is a retrospective observational study of adults with diabetes admitted for COVID-19. Bivariate tests and multivariable Cox regression were used to identify risk factors for severe COVID-19, defined as a composite endpoint of intensive care unit admission/intubation or in-hospital death.

Results: In 1134 patients with diabetes admitted for COVID-19, more severe disease was associated with older age (HR 1.02, p<0.001), male sex (HR 1.28, p=0.017), Asian race (HR 1.34, p=0.029 [reference: white]), and greater obesity (moderate obesity HR 1.59, p=0.015; severe obesity HR 2.07, p=0.002 [reference: normal body mass index]). Outpatient diabetes medications were not associated with outcomes.

Conclusions: Age, male sex, Asian race, and obesity were associated with increased risk of severe COVID-19 disease in adults with type 2 diabetes hospitalized for COVID-19.

Summary: In patients with type 2 diabetes hospitalized for COVID-19 disease, we observed that age, male sex, Asian race, and obesity predicted severe COVID-19 outcomes of intensive care unit admission, intubation, or in-hospital death. The risk conferred by obesity increased with worsening obesity. Outpatient diabetes medications were not observed to be significant predictors of study outcomes.

Keywords: Asian; COVID-19; Mortality; Obesity; Race; Type 2 diabetes mellitus.

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Conflict of interest statement

LJA reports receiving consulting fees from and serving on advisory boards for Jamieson Laboratories, Pfizer, Novo Nordisk, Eisai, Erx Pharmaceuticals, Real Appeal, Janssen Pharmaceuticals, and Gelesis; receiving research funding from Aspire Bariatrics, Allurion, Eisai, AstraZeneca, Gelesis, Janssen Pharmaceuticals and Novo Nordisk; having equity interests in Intellihealth Corp, Allurion, Erx Pharmaceuticals, Zafgen, Gelesis, Myos Corp., and Jamieson Laboratories; and serving on a board of directors for Intellihealth Corp., Myos Corp. and Jamieson Laboratories. MMS reports receiving salary support for investigator-initiated research unrelated to the topic from Amgen, Inc. BGT serves as a consultant for Novo Nordisk. All other authors have nothing to disclose.

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References

1. Chen Y., Yang D., Cheng B., et al. Clinical characteristics and outcomes of patients with diabetes and COVID-19 in association with glucose-lowering medication. Diabetes Care. 2020;43:1399–1407. - PubMed
1. Cariou B., Hadjadj S., Wargny M., et al. Phenotypic characteristics and prognosis of inpatients with COVID-19 and diabetes: the CORONADO study. Diabetologia. 2020;63:1500–1515. - PMC - PubMed
1. Agarwal S., Schechter C., Southern W., et al. Preadmission diabetes-specific risk factors for mortality in hospitalized patients with diabetes and coronavirus disease 2019. Diabetes Care. 2020;43:2339–2344. - PMC - PubMed
1. Pérez-Belmonte L.M., Torres-Peña J.D., López-Carmona M.D., et al. Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort study. BMC Med. 2020;18 - PMC - PubMed
1. Hajifathalian K, Kumar S, Newberry C, et al. Obesity is associated with worse outcomes in COVID-19: analysis of early data from New York City. Obesity (Silver Spring, Md) 2020;28: 1606-1612. - PMC - PubMed

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[1] Chen Y., Yang D., Cheng B., et al. Clinical characteristics and outcomes of patients with diabetes and COVID-19 in association with glucose-lowering medication. Diabetes Care. 2020;43:1399–1407. - PubMed

[2] Chen Y., Yang D., Cheng B., et al. Clinical characteristics and outcomes of patients with diabetes and COVID-19 in association with glucose-lowering medication. Diabetes Care. 2020;43:1399–1407. - PubMed

[3] Cariou B., Hadjadj S., Wargny M., et al. Phenotypic characteristics and prognosis of inpatients with COVID-19 and diabetes: the CORONADO study. Diabetologia. 2020;63:1500–1515. - PMC - PubMed

[4] Cariou B., Hadjadj S., Wargny M., et al. Phenotypic characteristics and prognosis of inpatients with COVID-19 and diabetes: the CORONADO study. Diabetologia. 2020;63:1500–1515. - PMC - PubMed

[5] Agarwal S., Schechter C., Southern W., et al. Preadmission diabetes-specific risk factors for mortality in hospitalized patients with diabetes and coronavirus disease 2019. Diabetes Care. 2020;43:2339–2344. - PMC - PubMed

[6] Agarwal S., Schechter C., Southern W., et al. Preadmission diabetes-specific risk factors for mortality in hospitalized patients with diabetes and coronavirus disease 2019. Diabetes Care. 2020;43:2339–2344. - PMC - PubMed

[7] Pérez-Belmonte L.M., Torres-Peña J.D., López-Carmona M.D., et al. Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort study. BMC Med. 2020;18 - PMC - PubMed

[8] Pérez-Belmonte L.M., Torres-Peña J.D., López-Carmona M.D., et al. Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort study. BMC Med. 2020;18 - PMC - PubMed

[9] Hajifathalian K, Kumar S, Newberry C, et al. Obesity is associated with worse outcomes in COVID-19: analysis of early data from New York City. Obesity (Silver Spring, Md) 2020;28: 1606-1612. - PMC - PubMed

[10] Hajifathalian K, Kumar S, Newberry C, et al. Obesity is associated with worse outcomes in COVID-19: analysis of early data from New York City. Obesity (Silver Spring, Md) 2020;28: 1606-1612. - PMC - PubMed

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Preadmission predictors of severe COVID-19 in patients with diabetes mellitus

Affiliations

Preadmission predictors of severe COVID-19 in patients with diabetes mellitus

Authors

Affiliations

Abstract

Conflict of interest statement

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Abstract

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