Smoking cessation in the elderly as a sign of susceptibility to symptomatic COVID-19 reinfection in the United States.

Background: We aimed to clarify the relationship between coronavirus disease 2019 (COVID-19) reinfection and basic disease and smoking status. Methods: The electronic health records of 165,320 patients with COVID-19 from January 1, 2020, to August 27, 2021, were analyzed. Data on age, race, sex, smoking status (never, current, former), and basic disease were analyzed using Cox proportional hazard models. Results: In total, 6,133 patients (3.7%) were reinfected. The overall reinfection rate for never, current, and former smokers was 4.2, 3.5, and 5.7%, respectively. Although the risk of reinfection was highest among former smokers aged ≥65 years (7.7% [422/5,460]), the reinfection rate among current smokers aged ≥65 years was 6.2% (341/5,543). Among reinfected patients, the number of basic diseases was higher in former smokers (2.41 ± 1.16) than in current (2.28 ± 1.07, P = 0.07) and never smokers (2.07 ± 1.05, P < 0.001). Former smokers who are older may have been exposed to factors that increase their risk of symptomatic COVID-19 reinfection.

Impact of overlapping risks of type 2 diabetes and obesity on coronavirus disease severity in the United States.

The impact of overlapping risk factors on coronavirus disease (COVID-19) severity is unclear. To evaluate the impact of type 2 diabetes (T2D) and obesity on COVID-19 severity, we conducted a cohort study with 28,095 anonymized COVID-19 patients using data from the COVID-19 Research Database from January 1, 2020 to November 30, 2020. The mean age was 50.8 ± 17.5 years, and 11,802 (42%) patients were male. Data on age, race, sex, T2D complications, antidiabetic medication prescription, and body mass index ≥ 30 kg/m2 (obesity) were analysed using Cox proportional hazard models, with hospitalization risk and critical care within 30 days of COVID-19 diagnosis as the main outcomes. The risk scores were 0-4 for age ≥ 65 years, male sex, T2D, and obesity. Among the participants, 11,294 (61.9%) had obesity, and 4445 (15.8%) had T2D. T2D, obesity, and male sex were significantly associated with COVID-19 hospitalization risk. Regarding hospitalization risk scores, compared with those for hospitalization risk score 0 and critical care risk score 0, hazard ratios [95% confidence intervals] were 19.034 [10.470-34.600] and 55.803 [12.761-244.015] (P < 0.001) (P < 0.001), respectively, for risk score 4. Complications from diabetes and obesity increased hospitalization and critical care risks for COVID-19 patients.

Risk Factor for COVID-19 Infection-Related Hospitalization in Patients with Type 2 Diabetes

Objective: Coronavirus disease (COVID-19) in 2019 is highly prevalent among patients with type 2 diabetes (T2D). Several factors, such as the older and obesity have been reported to be risks of COVID-19 infection, but little is known about the clinical factors limited to patients with T2D. Here, we aimed to identify clinical factors linked to hospitalization with COVID-19 infection in T2D. Research Design and Methods: We used data from Electronic Medical Record (EHR) registered in the Healthjump database provided by the COVID-19 Research Database consortium. Primary outcomes were to determine clinical factors linked to COVID-19 infection-associated hospitalization. Results: Of 4,445 T2D patients with COVID-19, hospitalization occurred in 228 (5.1%). The risk of Covid-19 infection-related hospitalization was higher with ≥65years old (hazard ratio [HR] 1.45;95% confidence interval [CI], 1.30-1.63), high in patients with a body-mass index (BMI) ≥30 kg/m2 (HR 1.59;95% CI, 1.10-2.31), and Blacks than in Caucasians (HR 1.39;95% CI, 1.04-1.85). The risk was lower in Metformin users (HR 0.56;95% CI, 0.34-1394) and SGLT2inhibitors users (HR 0.45;95% CI, 0.22-0.91). Asians tended to be at increased risk, but there was no significant difference due to the small number of cases (HR 1.88;95% CI, 0.59-5.96). Conclusions: We revealed that the risk of hospitalization may be higher with older, obesity and blacks. Furthermore, we discovered a low risk of hospitalization in patients with treated SGLT2 inhibitors and/or metformin. These findings can help inform patient-centered care decision making for people with T2D at risk for COVID-19.