1062. Examining the impact of type 2 diabetes status and severity on in-hospital outcomes amongst patients hospitalized with COVID-19 in a southwest Virginia healthcare system

Abstract

Abstract Background Patients with type 2 diabetes mellitus (T2DM) who develop COVID-19 are at increased risk of hospitalization, longer hospital stays, ICU admission, and death. Additionally, measures of T2DM severity (e.g., hemoglobin A1c) have been found to be predictive of severe COVID-19. The present analysis was conducted to determine whether T2DM status and severity may be predictive of COVID-19 severity outcomes amongst patients hospitalized with COVID-19 in a southwest Virginia healthcare system. Methods All non-pregnant patients over the age of 18 who were hospitalized with COVID-19 on or before 6/11/2021 were included (n=2,099). T2DM status was treated as a binary variable; patients diagnosed with non-T2DM diabetes mellitus were excluded. Diabetes severity was quantified using the Diabetes Complications Severity Index (DCSI), a 13-point summary score covering 7 discrete categories of diabetes complications. We used two binary indicators of in-hospital COVID-19 severity: (1) progression to ICU admission, ventilatory assistance, and/or death; and (2) in-hospital mortality. Binary logistic regression with propensity score weighting was used to assess the relationship between diabetes status and COVID-19 severity. Multivariate logistic regression was used to assess the relationship between DCSI score and COVID-19 severity. Results Patients with T2DM had 1.51 times the odds of progressing to ICU admission, ventilatory assistance, and/or death (95% CI: 1.16, 1.96) and 1.39 times the odds of in-hospital mortality (95% CI: 1.02, 1.91) compared to non-diabetics. Amongst patients with T2DM (n=942), increasing DCSI score was associated with increased odds of in-hospital mortality; compared to patients with a DCSI score of 0, patients with a DCSI score of 1 had 3.23 times the odds (95% CI: 1.20, 8.70) and patients with a DCSI score of 5 or greater had 11.25 times the odds (95% CI: 4.46, 28.40) of dying in the hospital. Conclusion Our results indicate that diabetes status and DCSI score were both strongly predictive of in-hospital COVID-19 severity outcomes amongst this sample. Future work will focus on how changes in vaccine coverage and strain dominance over time may have affected these relationships. Disclosures All Authors: No reported disclosures.