Abstract
Introduction: Diabetes mellitus is a known risk factor for COVID-19. It remains unknown if these patients suffer worse cardiovascular outcomes following COVID-19 infection. This study aimed to determine if COVID-19 patients with diabetes are at increased risk of hospitalization and acute myocardial infarction. Methods: A real-time search and analysis were performed for adult patients (≥ 18 years old) diagnosed with COVID-19 using the TriNetX (Cambridge, MA, USA) Research Network. TriNetX provided real-time access to electronic medical records (EMR) for o ver 53 million patients from 42 healthcare organizations (HCOs). COVID-19 patients were divided into those with documented diabetes mellitus within 12 months of CoVid-19 diagnosis and those without diabetes. Likelihood of hospitalization and acute myocardial infarction, defined using International Classification of Diseases, 10th Revision, Clinical Modification code I21, were compared between groups with and without propensity score matching for confounding factors. Results: Out of 53,516,662 patients, 28,893 patients were identified with COVID-19 of whom 4,543 (15.7%) were diabetic. COVID-19 patients with diabetes were older (62.5 ± 15.0 years vs. 53.2 ± 19.3 years, p<0.001), more frequently male (51.1% vs. 44.8%, p<0.001), and African- American (38.6% vs. 19.8%, p<0.001). After propensity matching on age, gender, race, BMI, chronic kidney disease, cerebrovascular disease, and disorders of the peripheral nervous system, likelihood of hospitalization was significantly increased in the diabetic cohort (risk ratio 1.16, 95% confidence interval [CI] 1.10-1.21, p<0.001). COVID-19 patients with diabetes were significantly more likely to suffer from acute myocardial infarction (risk ratio 1.32, 95% confidence interval [CI] 1.03-1.68, p=0.03) compared to COVID-19 patients without diabetes. Conclusions: This study suggests that COVID-19 patients with diabetes have increased likelihood of hospitalization and acute myocardial infarction compared to non-diabetic COVID-19 patients.
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