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Hospitalization and mortality in patients with COVID-19 with or at risk of type 2 diabetes: data from five health systems in Pennsylvania and Maryland.
Yeh, Hsin-Chieh; Kraschnewski, Jennifer L; Kong, Lan; Lehman, Erik B; Heilbrunn, Emily S; Williams, Pamela; Poger, Jennifer M; Francis, Erica; Bryce, Cindy L.
  • Yeh HC; Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA hyeh1@jhmi.edu.
  • Kraschnewski JL; Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA.
  • Kong L; Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA.
  • Lehman EB; Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA.
  • Heilbrunn ES; Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA.
  • Williams P; Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA.
  • Poger JM; Cancer and Chronic Disease Bureau, Maryland Department of Health, Baltimore, Maryland, USA.
  • Francis E; Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA.
  • Bryce CL; Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA.
BMJ Open Diabetes Res Care ; 10(3)2022 06.
Article in English | MEDLINE | ID: covidwho-1950101
ABSTRACT

OBJECTIVE:

To identify the demographic and clinical characteristics associated with adverse COVID-19 outcomes across a 12-month period in 2020 and 2021. RESEARCH DESIGN AND

METHODS:

We conducted a retrospective cohort study using electronic health records from five academic health systems in Pennsylvania and Maryland, including patients with COVID-19 with type 2 diabetes or at risk of type 2 diabetes. Patients were classified based on 30-day

outcomes:

(1) no hospitalization; (2) hospitalization only; or (3) a composite measure including admission to the intensive care unit (ICU), intubation, or death. Analyses were conducted in patients with type 2 diabetes and patients at risk of type 2 diabetes separately.

RESULTS:

We included 15 725 patients with COVID-19 diagnoses between March 2020 and February 2021. Older age and higher Charlson Comorbidity Index scores were associated with higher odds of adverse outcomes, while COVID-19 diagnoses later in the study period were associated with lower odds of severe outcomes. In patients with type 2 diabetes, individuals on insulin treatment had higher odds for ICU/intubation/death (OR=1.59, 95% CI 1.27 to 1.99), whereas those on metformin had lower odds (OR=0.56, 95% CI 0.45 to 0.71). Compared with non-Hispanic White patients, Hispanic patients had higher odds of hospitalization in patients with type 2 diabetes (OR=1.73, 95% CI 1.36 to 2.19) or at risk of type 2 diabetes (OR=1.77, 95% CI 1.43 to 2.18.)

CONCLUSIONS:

Adults who were older, in racial minority groups, had multiple chronic conditions or were on insulin treatment had higher risks for severe COVID-19 outcomes. This study reinforced the urgency of preventing COVID-19 and its complications in vulnerable populations. TRIAL REGISTRATION NUMBER NCT02788903.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetes Mellitus, Type 2 / Insulins / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Humans Country/Region as subject: North America Language: English Year: 2022 Document Type: Article Affiliation country: Bmjdrc-2022-002774

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetes Mellitus, Type 2 / Insulins / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Humans Country/Region as subject: North America Language: English Year: 2022 Document Type: Article Affiliation country: Bmjdrc-2022-002774