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Associations of type 1 and type 2 diabetes with COVID-19-related mortality in England: a whole-population study.
Barron, Emma; Bakhai, Chirag; Kar, Partha; Weaver, Andy; Bradley, Dominique; Ismail, Hassan; Knighton, Peter; Holman, Naomi; Khunti, Kamlesh; Sattar, Naveed; Wareham, Nicholas J; Young, Bob; Valabhji, Jonathan.
  • Barron E; Public Health England, York, UK.
  • Bakhai C; NHS England and NHS Improvement, London, UK.
  • Kar P; NHS England and NHS Improvement, London, UK; Portsmouth Hospitals NHS Trust, Portsmouth, UK.
  • Weaver A; NHS England and NHS Improvement, London, UK.
  • Bradley D; NHS England and NHS Improvement, London, UK.
  • Ismail H; NHS England and NHS Improvement, London, UK.
  • Knighton P; NHS Digital, Leeds, UK.
  • Holman N; NHS England and NHS Improvement, London, UK; NHS Digital, Leeds, UK; Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK.
  • Khunti K; Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.
  • Sattar N; Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK.
  • Wareham NJ; MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
  • Young B; Diabetes UK, London, UK.
  • Valabhji J; NHS England and NHS Improvement, London, UK; Department of Diabetes and Endocrinology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK; Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK. Electronic address: jonathan.valabhji@nhs.net.
Lancet Diabetes Endocrinol ; 8(10): 813-822, 2020 10.
Article in English | MEDLINE | ID: covidwho-712030
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Patients
Subject
COVID-19
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PROCESS_OF
Object
Patients
2. Death in hospital PROCESS_OF Patients
Subject
Death in hospital
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PROCESS_OF
Object
Patients
3. Cardiovascular LOCATION_OF Comorbidity
Subject
Cardiovascular
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LOCATION_OF
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Comorbidity
4. COVID-19 AFFECTS Death in hospital
Subject
COVID-19
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AFFECTS
Object
Death in hospital
5. Diabetes PROCESS_OF Persons
Subject
Diabetes
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PROCESS_OF
Object
Persons
6. Diagnosis DIAGNOSES Diabetes Mellitu
Subject
Diagnosis
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DIAGNOSES
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Diabetes Mellitu
7. Diabetes Mellitu PROCESS_OF C0027361
Subject
Diabetes Mellitu
Predicate
PROCESS_OF
Object
C0027361
8. Death in hospital PROCESS_OF Persons
Subject
Death in hospital
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PROCESS_OF
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Persons
9. GJA1 gene|GJA1 ASSOCIATED_WITH Diabetes Mellitu
Subject
GJA1 gene|GJA1
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ASSOCIATED_WITH
Object
Diabetes Mellitu
10. COVID-19 PROCESS_OF Patients
Subject
COVID-19
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PROCESS_OF
Object
Patients
11. Death in hospital PROCESS_OF Patients
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Death in hospital
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PROCESS_OF
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Patients
12. Cardiovascular LOCATION_OF Comorbidity
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Cardiovascular
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LOCATION_OF
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Comorbidity
13. COVID-19 AFFECTS Death in hospital
Subject
COVID-19
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AFFECTS
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Death in hospital
14. Diabetes PROCESS_OF Persons
Subject
Diabetes
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PROCESS_OF
Object
Persons
15. Diagnosis DIAGNOSES Diabetes Mellitus, Non-Insulin-Dependent
Subject
Diagnosis
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DIAGNOSES
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Diabetes Mellitus, Non-Insulin-Dependent
16. Diabetes Mellitus, Insulin-Dependent PROCESS_OF Persons
Subject
Diabetes Mellitus, Insulin-Dependent
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PROCESS_OF
Object
Persons
17. Diabetes Mellitus, Non-Insulin-Dependent PROCESS_OF Persons
Subject
Diabetes Mellitus, Non-Insulin-Dependent
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PROCESS_OF
Object
Persons
18. Death in hospital PROCESS_OF Persons
Subject
Death in hospital
Predicate
PROCESS_OF
Object
Persons
19. GJA1 gene|GJA1 ASSOCIATED_WITH Diabetes Mellitus, Non-Insulin-Dependent
Subject
GJA1 gene|GJA1
Predicate
ASSOCIATED_WITH
Object
Diabetes Mellitus, Non-Insulin-Dependent
ABSTRACT

BACKGROUND:

Although diabetes has been associated with COVID-19-related mortality, the absolute and relative risks for type 1 and type 2 diabetes are unknown. We assessed the independent effects of diabetes status, by type, on in-hospital death in England in patients with COVID-19 during the period from March 1 to May 11, 2020.

METHODS:

We did a whole-population study assessing risks of in-hospital death with COVID-19 between March 1 and May 11, 2020. We included all individuals registered with a general practice in England who were alive on Feb 16, 2020. We used multivariable logistic regression to examine the effect of diabetes status, by type, on in-hospital death with COVID-19, adjusting for demographic factors and cardiovascular comorbidities. Because of the absence of data on total numbers of people infected with COVID-19 during the observation period, we calculated mortality rates for the population as a whole, rather than the population who were infected.

FINDINGS:

Of the 61 414 470 individuals who were alive and registered with a general practice on Feb 16, 2020, 263 830 (0·4%) had a recorded diagnosis of type 1 diabetes, 2 864 670 (4·7%) had a diagnosis of type 2 diabetes, 41 750 (0·1%) had other types of diabetes, and 58 244 220 (94·8%) had no diabetes. 23 698 in-hospital COVID-19-related deaths occurred during the study period. A third occurred in people with diabetes 7434 (31·4%) in people with type 2 diabetes, 364 (1·5%) in those with type 1 diabetes, and 69 (0·3%) in people with other types of diabetes. Unadjusted mortality rates per 100 000 people over the 72-day period were 27 (95% CI 27-28) for those without diabetes, 138 (124-153) for those with type 1 diabetes, and 260 (254-265) for those with type 2 diabetes. Adjusted for age, sex, deprivation, ethnicity, and geographical region, compared with people without diabetes, the odds ratios (ORs) for in-hospital COVID-19-related death were 3·51 (95% CI 3·16-3·90) in people with type 1 diabetes and 2·03 (1·97-2·09) in people with type 2 diabetes. These effects were attenuated to ORs of 2·86 (2·58-3·18) for type 1 diabetes and 1·80 (1·75-1·86) for type 2 diabetes when also adjusted for previous hospital admissions with coronary heart disease, cerebrovascular disease, or heart failure.

INTERPRETATION:

The results of this nationwide analysis in England show that type 1 and type 2 diabetes were both independently associated with a significant increased odds of in-hospital death with COVID-19.

FUNDING:

None.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Population Surveillance / Hospital Mortality / Coronavirus Infections / Diabetes Mellitus, Type 1 / Diabetes Mellitus, Type 2 / Betacoronavirus Type of study: Diagnostic study / Prognostic study / Risk factors / Screening study Limits: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Lancet Diabetes Endocrinol Year: 2020 Document Type: Article Affiliation country: S2213-8587(20)30272-2

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Population Surveillance / Hospital Mortality / Coronavirus Infections / Diabetes Mellitus, Type 1 / Diabetes Mellitus, Type 2 / Betacoronavirus Type of study: Diagnostic study / Prognostic study / Risk factors / Screening study Limits: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Lancet Diabetes Endocrinol Year: 2020 Document Type: Article Affiliation country: S2213-8587(20)30272-2