Higher rate of covid-19 mortality in patients with type 1 than type 2 diabetes: a nationwide study

Abstract

PurposeCOVID-19 disease has a worse prognosis in patients with diabetes, but the 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.MethodsA 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 the non-diabetics (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.ResultsThe patients with T1DM had higher mortality than the age and gender matched patients with T2DM (n=489) and the non-diabetics (n=489) (p<0.001). After further adjustment for the A1c, 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 lymphopenia (OR:5.13, 95% CI:1.04–25.5, p=0.045) were independently associated with mortality in patients with T1DM.ConclusionAccording to the results, patients with T1DM had poorer COVID-19 prognosis than those with T2DM or the non-diabetics. These patients should be cared diligently until more data will be available about the causes of increased COVID-19 mortality in T1DM.

Comorbidities increase COVID ‐19 hospitalization in young people with type 1 diabetes

“…The few reports on outcomes for children or adults with type 1 diabetes (T1D) are mixed in terms of severity of disease and mortality compared to people without diabetes 2–6 . For adults with type 1 diabetes (T1D), having a co‐existing medical diagnosis such as cardiovascular disease, hypertension, or renal disease increases the risk of suffering from severe COVID‐19 and adverse outcomes 4,5,7–11 . However, few published studies examine the relationship between comorbidities and severity of COVID‐19 infection in children with T1D.…”

“…[2][3][4][5][6] For adults with type 1 diabetes (T1D), having a co-existing medical diagnosis such as cardiovascular disease, hypertension, or renal disease increases the risk of suffering from severe COVID-19 and adverse outcomes. 4,5,[7][8][9][10][11] However, few published studies examine the relationship between comorbidities and severity of COVID-19 infection in children with T1D.…”

Severe Covid-19 infection in type 1 and type 2 diabetes mellitus during the first three waves in Sweden

“…Severe COVID-19 Infection in Type 1 and Type 2 Diabetes During the First Three Waves in Sweden inflammatory responses (2). Although patients with type 1 diabetes have been found to have increased in-hospital mortality (3), findings regarding fatal cases among patients with type 1 diabetes have been heterogeneous, ranging from no statistically increased risk of death with COVID-19 (4) to a worse prognosis among patients with confirmed COVID-19 infection and type 1 diabetes compared with those with type 2 or no diabetes (5). In a report from the first few months of the pandemic through 17 August 2020, only 21 deaths were identified among 44,639 people with type 1 diabetes registered in the Swedish National Diabetes Register.…”