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. 2023 May 4:14:1161637.
doi: 10.3389/fendo.2023.1161637. eCollection 2023.

Diabetes as a risk factor of death in hospitalized COVID-19 patients - an analysis of a National Hospitalization Database from Poland, 2020

Michal Kania  1   2 , Beata Koń  3 , Konrad Kamiński  3 , Jerzy Hohendorff  1   2 , Przemysław Witek  1   2 , Tomasz Klupa  1   2 , Maciej T Malecki  1   2
Affiliations

Diabetes as a risk factor of death in hospitalized COVID-19 patients - an analysis of a National Hospitalization Database from Poland, 2020

Michal Kania et al. Front Endocrinol (Lausanne). .

Erratum in

Abstract

Introduction: Diabetes is one of the comorbidities associated with poor prognosis in hospitalized COVID-19 patients. In this nationwide retrospective study, we evaluated the risk of in-hospital death attributed to diabetes.

Methods: We analyzed data from discharge reports of patients hospitalized with COVID-19 in 2020 as submitted to the Polish National Health Fund. Several multivariate logistic regression models were used. In each model, in-hospital death was estimated with explanatory variables. Models were built either on the whole cohorts or cohorts matched with propensity score matching (PSM). The models examined either the main effects of diabetes itself or the interaction of diabetes with other variables.

Results: We included 174,621 patients with COVID-19 who were hospitalized in the year 2020. Among them, there were 40,168 diabetic patients (DPs), and the proportion of DPs in this group was higher than in the general population (23.0% vs. 9.5%, p<0.001). In this group of COVID-19 hospitalizations, 17,438 in-hospital deaths were recorded, and the mortality was higher among DPs than non-diabetics (16.3% vs. 8.1%, p<0.001). Multivariate logistic regressions showed that diabetes was a risk factor of death, regardless of sex and age. In the main effect analysis, odds of in-hospital death were higher by 28.3% for DPs than for non-diabetic patients. Similarly, PSM analysis including 101,578 patients, of whom 19,050 had diabetes, showed that the risk of death was higher in DPs regardless of sex with odds higher by 34.9%. The impact of diabetes differed among age groups and was the highest for patients aged 60-69.

Conclusions: This nationwide study confirmed that diabetes was an independent risk factor of in-hospital death in the course of COVID-19 infection. However, the relative risk differed across the age groups.

Keywords: COVID-19; diabetes; epidemiology; modelling; mortality; propensity-score matching.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Probability of in-hospital death in the examined groups according to age and sex estimated with multivariate logistic regression without PSM and with interaction analysis for patients without other comorbidities.
Figure 2
Figure 2
Probability of in-hospital death in the examined groups according to age and sex estimated with multivariate logistic regression without PSM and with interaction analysis.
Figure 3
Figure 3
Probability of in-hospital death in the examined groups according to age and sex estimated with multivariate logistic regression with PSM and with interaction analysis for patients without other comorbidities.
Figure 4
Figure 4
Probability of in-hospital death in the examined groups according to age and sex estimated with multivariate logistic regression with PSM and with interaction analysis.
See this image and copyright information in PMC

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