ABSTRACT
AIM: To compare adverse outcomes among COVID-19 patients with pre-existing type 2 diabetes (T2D) only, T2D and cardiovascular disease (CVD), or neither. METHODS: This retrospective cohort study used administrative claims, laboratory and mortality data from the HealthCore Integrated Research Database. Patients with COVID-19 were identified from 3 January 2020 to 31 May 2021 and stratified by the presence of T2D and CVD. Outcomes included hospitalization, intensive care unit (ICU) admission, mortality and complications following COVID-19 infection. Propensity score matching and multivariable analyses were performed. RESULTS: A total of 321 232 COVID-19 patients were identified (21 651 T2D + CVD, 28 184 T2D only, and 271 397 neither) with a mean (SD) follow-up of 5.4 (3.0) months. After matching, 6 967 patients were identified for each group, and residual baseline differences remained. Adjusted analyses showed that COVID-19 patients with T2D + CVD were 59% more probable to be hospitalized, 74% more probable to be admitted to the ICU, and had a 26% higher mortality risk than those with neither. COVID-19 patients with T2D only were 28% and 32% more probable to be admitted to the hospital and ICU than those with neither, respectively. Among all T2D + CVD patients, acute respiratory distress syndrome (31%) and acute kidney disease (24%) were observed. CONCLUSION: Our study highlights the incrementally poorer outcomes associated with pre-existing T2D + CVD in COVID-19 patients compared with those without T2D/CVD and suggests consideration of a more optimal management approach in these patients.
ABSTRACT
Objective: The association of T2D and severe C-19 outcomes has been reported, but data are scarce on whether pre-existing CVD impacts C-19 outcomes in T2D patients. This study compared the clinical outcomes among C-19 patients with pre-existing T2D, T2D+CVD, or neither. Methods: Retrospective study of claims and lab data to identify C-19 patients from 3/1/20 - 5/31/21 and stratify them by the presence of T2D and CVD. Outcomes included hospital/ICU admission and mortality. Propensity score matching and multivariable analyses were performed. Results: After matching, 6,967 patients were identified for each group with a mean follow-up of 5.4 months;minimal residual baseline differences remained. Adjusted analyses (Table) show that C-19 patients with T2D+CVD or T2D only were more likely to be admitted to the hospital/ICU than those with neither (all p <0.01) , with the T2D+CVD group having greater odds. C-19 patients with T2D+CVD had a higher mortality risk compared to those with neither (p=0.02) . Among all T2D+CVD patients, acute respiratory distress syndrome (31%) , acute kidney disease (24%) , and ventilator use (8%) were observed. Conclusion: Our study highlights the incrementally poorer outcomes associated with pre-existing T2D+CVD in C-19 patients and may suggest consideration of a more aggressive management approach in these patients with a less favorable prognosis.