Race/Ethnicity Disparities of presenting symptoms and outcomes among patients with type 1 diabetes with confirmed or suspected COVID-19 in the United States

ABSTRACT

Introduction: While there is rapidly emerging information describing race or ethnicity outcome disparities of patients hospitalized with COVID-19, no such data is available for people with type 1 diabetes (T1D). Objectives: This U.S. based, multi-center surveillance study aimed to investigate racial disparities among presenting symptoms, and adverse outcomes of patients with T1D who tested positive for SARS CoV-2 (N = 26) or are suspected to have COVID-19. As a secondary objective, this study also reports differences in access to SARS CoV-2 testing by racial group (Non-Hispanic White versus Minority) by analyzing data among T1D patients with COVID-like symptoms (N = 24) who were unable to get tested. Methods: De-identified patient data was collected through T1D Exchange's Type 1 Diabetes-COVID-19 Registry. Patient information for people who tested positive for SARS CoV-2, and patients suspected to have COVID-19 were reported by healthcare providers from U.S. Endocrinology clinics. Racial groups were classified as Non- Hispanic White (NH White) or minority (all other races). Results: We analyzed 50 patients with T1D, of which 25 (50%) were reported NH White, 10 (20.0%) Hispanic, 10 (20.0%) Non-Hispanic Black, 1 (2%) Asian, and 2 (4.0%) other. The mean age of the NH White population was 19.2 years (SD = 12.25, Range = 6.0-61.0), and 44% were female. Among the NH White population (N = 25), the reported highest level of care at the time of reporting was ICU at 16.6%, compared to 26.1% of the minority population (N = 23). Of the NH White population, 60% were tested for SARS CoV-2, compared to 36% of the minority population. The most prevalent adverse T1D outcome was diabetic ketoacidosis in both NH White (16.67%) and minority (34.78%) populations. Two patient deaths were recorded, one with confirmed COVID-19, both of Hispanic origin. Conclusions: This study provides racial differences in clinical outcomes of patients with T1D with confirmed or suspected COVID-19 in the United States.