tetano
Editor, Senior Moderator
Endokrynol Pol
. 2022 Feb 4.
doi: 10.5603/EP.a2022.0008. Online ahead of print.
Higher rate of COVID-19 mortality in patients with type 1 than type 2 diabetes: a nationwide study
Ibrahim Demirci[SUP] 1 [/SUP], Cem Haymana[SUP] 2 [/SUP], Ilker Tasci[SUP] 3 [/SUP], Ilhan Satman[SUP] 4 5 [/SUP], Aysegul Atmaca[SUP] 6 [/SUP], Mustafa Sahin[SUP] 7 [/SUP], Naim Ata[SUP] 8 [/SUP], Ugur Unluturk[SUP] 9 [/SUP], Erman Cakal[SUP] 10 [/SUP], Selcuk Dagdelen[SUP] 9 [/SUP], Ibrahim Sahin[SUP] 11 [/SUP], Osman Celik[SUP] 12 [/SUP], Derun Ertugrul[SUP] 13 [/SUP], Tevfik Demir[SUP] 14 [/SUP], Rifat Emral[SUP] 7 [/SUP], Murat Caglayan[SUP] 15 [/SUP], Serpil Salman[SUP] 16 [/SUP], Suayip Birinci[SUP] 17 [/SUP], Alper Sonmez[SUP] 18 [/SUP]
Affiliations
Abstract
Introduction: COVID-19 disease has a worse prognosis in patients with diabetes, but comparative data about the course of COVID-19 in patients with type 1 (T1DM) and type 2 diabetes (T2DM) are lacking. The purpose of this study was to find out the relative clinical severity and mortality of COVID-19 patients with T1DM and T2DM.
Material and methods: A nationwide retrospective cohort of patients with confirmed (PCR positive) COVID-19 infection (n = 149,671) was investigated. After exclusion of individuals with unspecified diabetes status, the adverse outcomes between patients with T1DM (n = 163), T2DM (n = 33,478) and those without diabetes (n = 115,108) were compared by using the propensity score matching method. The outcomes were hospitalization, the composite of intensive care unit (ICU) admission and/or mechanical ventilation, and mortality.
Results: The patients with T1DM had higher mortality than the age- and gender-matched patients with T2DM (n = 489) and those without diabetes (n = 489) (p < 0.001). After further adjustment for the HbA1c, and microvascular and macrovascular complications, the odds of mortality (OR: 3.35, 95% CI: 1.41-7.96, p = 0.006) and ICU admission and/or mechanical ventilation (OR: 2.95, 95% CI: 1.28-6.77, p = 0.011) were significantly higher in patients with T1DM compared to those with T2DM. Older age (OR: 1.06, 95% CI: 1.01-1.12, p = 0.028) and lymphopaenia (OR: 5.13, 95% CI: 1.04-25.5, p = 0.045) were independently associated with mortality in patients with T1DM.
Conclusions: Patients with T1DM had worse prognosis of COVID-19 compared to T2DM patients or those without diabetes. These cases should be cared for diligently until more data become available about the causes of increased COVID-19 mortality in T1DM.
Keywords: COVID-19; T1DM; Turkey; coronavirus; diabetes mellitus; mortality; type 1 diabetes.
. 2022 Feb 4.
doi: 10.5603/EP.a2022.0008. Online ahead of print.
Higher rate of COVID-19 mortality in patients with type 1 than type 2 diabetes: a nationwide study
Ibrahim Demirci[SUP] 1 [/SUP], Cem Haymana[SUP] 2 [/SUP], Ilker Tasci[SUP] 3 [/SUP], Ilhan Satman[SUP] 4 5 [/SUP], Aysegul Atmaca[SUP] 6 [/SUP], Mustafa Sahin[SUP] 7 [/SUP], Naim Ata[SUP] 8 [/SUP], Ugur Unluturk[SUP] 9 [/SUP], Erman Cakal[SUP] 10 [/SUP], Selcuk Dagdelen[SUP] 9 [/SUP], Ibrahim Sahin[SUP] 11 [/SUP], Osman Celik[SUP] 12 [/SUP], Derun Ertugrul[SUP] 13 [/SUP], Tevfik Demir[SUP] 14 [/SUP], Rifat Emral[SUP] 7 [/SUP], Murat Caglayan[SUP] 15 [/SUP], Serpil Salman[SUP] 16 [/SUP], Suayip Birinci[SUP] 17 [/SUP], Alper Sonmez[SUP] 18 [/SUP]
Affiliations
- PMID: 35119089
- DOI: 10.5603/EP.a2022.0008
Abstract
Introduction: COVID-19 disease has a worse prognosis in patients with diabetes, but comparative data about the course of COVID-19 in patients with type 1 (T1DM) and type 2 diabetes (T2DM) are lacking. The purpose of this study was to find out the relative clinical severity and mortality of COVID-19 patients with T1DM and T2DM.
Material and methods: A nationwide retrospective cohort of patients with confirmed (PCR positive) COVID-19 infection (n = 149,671) was investigated. After exclusion of individuals with unspecified diabetes status, the adverse outcomes between patients with T1DM (n = 163), T2DM (n = 33,478) and those without diabetes (n = 115,108) were compared by using the propensity score matching method. The outcomes were hospitalization, the composite of intensive care unit (ICU) admission and/or mechanical ventilation, and mortality.
Results: The patients with T1DM had higher mortality than the age- and gender-matched patients with T2DM (n = 489) and those without diabetes (n = 489) (p < 0.001). After further adjustment for the HbA1c, and microvascular and macrovascular complications, the odds of mortality (OR: 3.35, 95% CI: 1.41-7.96, p = 0.006) and ICU admission and/or mechanical ventilation (OR: 2.95, 95% CI: 1.28-6.77, p = 0.011) were significantly higher in patients with T1DM compared to those with T2DM. Older age (OR: 1.06, 95% CI: 1.01-1.12, p = 0.028) and lymphopaenia (OR: 5.13, 95% CI: 1.04-25.5, p = 0.045) were independently associated with mortality in patients with T1DM.
Conclusions: Patients with T1DM had worse prognosis of COVID-19 compared to T2DM patients or those without diabetes. These cases should be cared for diligently until more data become available about the causes of increased COVID-19 mortality in T1DM.
Keywords: COVID-19; T1DM; Turkey; coronavirus; diabetes mellitus; mortality; type 1 diabetes.