Predictors of Severe COVID-19 in Patients With Diabetes: A Multicenter Review

Megan M. Kristan, Yoon K. Kim, Toby Nelson, Meaghan C. Moxley, Terry Cheuk Fung Yip, Kashif Munir, Rana Malek

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

OBJECTIVE: Diabetes is an independent risk factor for severe SARS-CoV-2 infections. This study aims to elucidate the risk factors predictive of more severe outcomes in patients with diabetes by comparing the clinical characteristics of those requiring inpatient admissions with those who remain outpatient.

METHODS: A retrospective review identified 832 patients-631 inpatients and 201 outpatients-with diabetes and a positive SARS-CoV-2 test result between March 1 and June 15, 2020. Comparisons between the outpatient and inpatient cohorts were conducted to identify risk factors associated with severity of disease determined by admission rate and mortality. Previous dipeptidyl peptidase 4 inhibitor use and disease outcomes were analyzed.

RESULTS: Risk factors for increased admission included older age (odds ratio [OR], 1.04 [95% CI, 1.01-1.06]; P = .003), the presence of chronic kidney disease (OR, 2.32 [1.26-4.28]; P = .007), and a higher hemoglobin A1c at the time of admission (OR, 1.25 [1.12-1.39]; P < .001). Lower admission rates were seen in those with commercial insurance. Increased mortality was seen in individuals with older age (OR, 1.09 [1.07-1.11]; P < .001), higher body mass index number (OR, 1.04 [1.01-1.07]; P = .003), and higher hemoglobin A1c value at the time of diagnosis of COVID-19 (OR, 1.12 [1.01-1.24]; P = .028) and patients requiring hospitalization. Lower mortality was seen in those with hyperlipidemia. Dipeptidyl peptidase 4 inhibitor use prior to COVID-19 infection was not associated with a decreased hospitalization rate.

CONCLUSION: This retrospective review offers the first analysis of outpatient predictors for admission rate and mortality of COVID-19 in patients with diabetes.

Original languageEnglish (US)
Pages (from-to)842-849
Number of pages8
JournalEndocrine Practice
Volume27
Issue number8
DOIs
StatePublished - Aug 2021
Externally publishedYes

Bibliographical note

Funding Information:
We acknowledge the support of the University of Maryland, Baltimore, Institute for Clinical & Translational Research (ICTR) and the National Center for Advancing Translational Sciences (NCATS) Clinical Translational Science Award (CTSA) grant number 1UL1TR003098.

Publisher Copyright:
© 2021 AACE

Keywords

  • COVID-19
  • DPP-4 inhibitor
  • health disparities
  • hospitalization
  • risk factors
  • SARS-CoV-2
  • Humans
  • Risk Factors
  • Aged
  • Hospitalization
  • Retrospective Studies
  • Diabetes Mellitus

PubMed: MeSH publication types

  • Multicenter Study
  • Journal Article

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