tetano
Editor, Senior Moderator
J Clin Endocrinol Metab
. 2021 Aug 18;106(9):e3364-e3368.
doi: 10.1210/clinem/dgab393.
Diabetes Increases Severe COVID-19 Outcomes Primarily in Younger Adults
Marc Diedisheim[SUP] 1 2 [/SUP], Etienne Dancoisne[SUP] 3 4 [/SUP], Jean-François Gautier[SUP] 1 5 [/SUP], Etienne Larger[SUP] 2 [/SUP], Emmanuel Cosson[SUP] 6 7 [/SUP], Bruno Fève[SUP] 8 9 10 [/SUP], Philippe Chanson[SUP] 11 12 [/SUP], Sébastien Czernichow[SUP] 13 14 [/SUP], Sopio Tatulashvili[SUP] 6 7 [/SUP], Marie-Laure Raffin-Sanson[SUP] 15 16 [/SUP], Kankoé Sallah[SUP] 4 [/SUP], Muriel Bourgeon[SUP] 17 [/SUP], Christiane Ajzenberg[SUP] 18 [/SUP], Agnès Hartemann[SUP] 19 [/SUP], Christel Daniel[SUP] 3 20 [/SUP], Thomas Moreau[SUP] 21 [/SUP], Ronan Roussel[SUP] 1 22 [/SUP], Louis Potier[SUP] 1 22 [/SUP]
Affiliations
Abstract
Context: Diabetes is reported as a risk factor for severe coronavirus disease 2019 (COVID-19), but whether this risk is similar in all categories of age remains unclear.
Objective: To investigate the risk of severe COVID-19 outcomes in hospitalized patients with and without diabetes according to age categories.
Design setting and participants: We conducted a retrospective observational cohort study of 6314 consecutive patients hospitalized for COVID-19 between February and 30 June 2020 in the Paris metropolitan area, France; follow-up was recorded until 30 September 2020.
Main outcome measure(s): The main outcome was a composite outcome of mortality and orotracheal intubation in subjects with diabetes compared with subjects without diabetes, after adjustment for confounding variables and according to age categories.
Results: Diabetes was recorded in 39% of subjects. Main outcome was higher in patients with diabetes, independently of confounding variables (hazard ratio
1.13 [1.03-1.24]) and increased with age in individuals without diabetes, from 23% for those <50 to 35% for those >80 years but reached a plateau after 70 years in those with diabetes. In direct comparison between patients with and without diabetes, diabetes-associated risk was inversely proportional to age, highest in <50 years and similar after 70 years. Similarly, mortality was higher in patients with diabetes (26%) than in those without diabetes (22%, P < 0.001), but adjusted HR for diabetes was significant only in patients younger than age 50 years (HR 1.81 [1.14-2.87]).
Conclusions: Diabetes should be considered as an independent risk factor for the severity of COVID-19 in young adults more so than in older adults, especially for individuals younger than 70 years.
Keywords: age; covid-19; diabetes; mortality.
. 2021 Aug 18;106(9):e3364-e3368.
doi: 10.1210/clinem/dgab393.
Diabetes Increases Severe COVID-19 Outcomes Primarily in Younger Adults
Marc Diedisheim[SUP] 1 2 [/SUP], Etienne Dancoisne[SUP] 3 4 [/SUP], Jean-François Gautier[SUP] 1 5 [/SUP], Etienne Larger[SUP] 2 [/SUP], Emmanuel Cosson[SUP] 6 7 [/SUP], Bruno Fève[SUP] 8 9 10 [/SUP], Philippe Chanson[SUP] 11 12 [/SUP], Sébastien Czernichow[SUP] 13 14 [/SUP], Sopio Tatulashvili[SUP] 6 7 [/SUP], Marie-Laure Raffin-Sanson[SUP] 15 16 [/SUP], Kankoé Sallah[SUP] 4 [/SUP], Muriel Bourgeon[SUP] 17 [/SUP], Christiane Ajzenberg[SUP] 18 [/SUP], Agnès Hartemann[SUP] 19 [/SUP], Christel Daniel[SUP] 3 20 [/SUP], Thomas Moreau[SUP] 21 [/SUP], Ronan Roussel[SUP] 1 22 [/SUP], Louis Potier[SUP] 1 22 [/SUP]
Affiliations
- PMID: 34406396
- DOI: 10.1210/clinem/dgab393
Abstract
Context: Diabetes is reported as a risk factor for severe coronavirus disease 2019 (COVID-19), but whether this risk is similar in all categories of age remains unclear.
Objective: To investigate the risk of severe COVID-19 outcomes in hospitalized patients with and without diabetes according to age categories.
Design setting and participants: We conducted a retrospective observational cohort study of 6314 consecutive patients hospitalized for COVID-19 between February and 30 June 2020 in the Paris metropolitan area, France; follow-up was recorded until 30 September 2020.
Main outcome measure(s): The main outcome was a composite outcome of mortality and orotracheal intubation in subjects with diabetes compared with subjects without diabetes, after adjustment for confounding variables and according to age categories.
Results: Diabetes was recorded in 39% of subjects. Main outcome was higher in patients with diabetes, independently of confounding variables (hazard ratio
1.13 [1.03-1.24]) and increased with age in individuals without diabetes, from 23% for those <50 to 35% for those >80 years but reached a plateau after 70 years in those with diabetes. In direct comparison between patients with and without diabetes, diabetes-associated risk was inversely proportional to age, highest in <50 years and similar after 70 years. Similarly, mortality was higher in patients with diabetes (26%) than in those without diabetes (22%, P < 0.001), but adjusted HR for diabetes was significant only in patients younger than age 50 years (HR 1.81 [1.14-2.87]).
Conclusions: Diabetes should be considered as an independent risk factor for the severity of COVID-19 in young adults more so than in older adults, especially for individuals younger than 70 years.
Keywords: age; covid-19; diabetes; mortality.