TY - JOUR
T1 - Impact of diabetes status and related factors on COVID-19-associated hospitalization
T2 - A nationwide retrospective cohort study of 116,370 adults with SARS-CoV-2 infection
AU - Tallon, Erin M.
AU - Ebekozien, Osagie
AU - Sanchez, Janine
AU - Staggs, Vincent S.
AU - Ferro, Diana
AU - McDonough, Ryan
AU - Demeterco-Berggren, Carla
AU - Polsky, Sarit
AU - Gomez, Patricia
AU - Patel, Neha
AU - Prahalad, Priya
AU - Odugbesan, Ori
AU - Mathias, Priyanka
AU - Lee, Joyce M.
AU - Smith, Chelsey
AU - Shyu, Chi Ren
AU - Clements, Mark A.
N1 - Funding Information:
EMT was supported by the National Institutes of Health under grant number 5T32LM012410. This manuscript’s content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Funding Information:
We thank the T1D Exchange Publications Committee – especially Ruth Weinstock, MD, PhD (SUNY Upstate Medical University, Syracuse, NY, USA) and Alissa Roberts, MD (Seattle Children's, Seattle, WA, USA) – for their valuable feedback pertaining to this manuscript.
Publisher Copyright:
© 2022
PY - 2022/12
Y1 - 2022/12
N2 - Aims: We examined diabetes status (no diabetes; type 1 diabetes [T1D]; type 2 diabetes [T2D]) and other demographic and clinical factors as correlates of coronavirus disease 2019 (COVID-19)-related hospitalization. Further, we evaluated predictors of COVID-19-related hospitalization in T1D and T2D. Methods: We analyzed electronic health record data from the de-identified COVID-19 database (December 2019 through mid-September 2020; 87 US health systems). Logistic mixed models were used to examine predictors of hospitalization at index encounters associated with confirmed SARS-CoV-2 infection. Results: In 116,370 adults (>=18 years old) with COVID-19 (93,098 no diabetes; 802 T1D; 22,470 T2D), factors that independently increased risk for hospitalization included diabetes, male sex, public health insurance, decreased body mass index (BMI; <25.0–29.9 kg/m2), increased BMI (>25.0–29.9 kg/m2), vitamin D deficiency/insufficiency, and Elixhauser comorbidity score. After further adjustment for concurrent hyperglycemia and acidosis in those with diabetes, hospitalization risk was substantially higher in T1D than T2D and in those with low vitamin D and elevated hemoglobin A1c (HbA1c). Conclusions: The higher hospitalization risk in T1D versus T2D warrants further investigation. Modifiable risk factors such as vitamin D deficiency/insufficiency, BMI, and elevated HbA1c may serve as prognostic indicators for COVID-19-related hospitalization in adults with diabetes.
AB - Aims: We examined diabetes status (no diabetes; type 1 diabetes [T1D]; type 2 diabetes [T2D]) and other demographic and clinical factors as correlates of coronavirus disease 2019 (COVID-19)-related hospitalization. Further, we evaluated predictors of COVID-19-related hospitalization in T1D and T2D. Methods: We analyzed electronic health record data from the de-identified COVID-19 database (December 2019 through mid-September 2020; 87 US health systems). Logistic mixed models were used to examine predictors of hospitalization at index encounters associated with confirmed SARS-CoV-2 infection. Results: In 116,370 adults (>=18 years old) with COVID-19 (93,098 no diabetes; 802 T1D; 22,470 T2D), factors that independently increased risk for hospitalization included diabetes, male sex, public health insurance, decreased body mass index (BMI; <25.0–29.9 kg/m2), increased BMI (>25.0–29.9 kg/m2), vitamin D deficiency/insufficiency, and Elixhauser comorbidity score. After further adjustment for concurrent hyperglycemia and acidosis in those with diabetes, hospitalization risk was substantially higher in T1D than T2D and in those with low vitamin D and elevated hemoglobin A1c (HbA1c). Conclusions: The higher hospitalization risk in T1D versus T2D warrants further investigation. Modifiable risk factors such as vitamin D deficiency/insufficiency, BMI, and elevated HbA1c may serve as prognostic indicators for COVID-19-related hospitalization in adults with diabetes.
UR - http://www.scopus.com/inward/record.url?scp=85142313471&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85142313471&partnerID=8YFLogxK
U2 - 10.1016/j.diabres.2022.110156
DO - 10.1016/j.diabres.2022.110156
M3 - Article
C2 - 36400172
AN - SCOPUS:85142313471
SN - 0168-8227
VL - 194
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
M1 - 110156
ER -